Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Eur J Cancer. 2013 Jul;49(10):2365-75. doi: 10.1016/j.ejca.2013.03.010. Epub 2013 Apr 20.
In this systematic review and meta-analysis the risk of a subsequent basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or melanoma in patients with a previous keratinocyte carcinoma (KC) was investigated. PubMed, Embase, Web of Science and the Cochrane library were searched for studies published before 1st January 2012 that reported risks (i.e. proportions, cumulative risks or standardised incidence ratios [SIR]) of developing a subsequent BCC, SCC or melanoma in patients with prior KC. 45 articles fulfilled the inclusion criteria. In BCC patients, the pooled proportion for a subsequent BCC, SCC or melanoma was respectively 29.2% (95% confidence interval (CI) 24.6-34.3%), 4.3% (1.7-10.1%) and 0.5% (0.4-0.8%). The pooled proportion of a subsequent SCC, BCC or melanoma in SCC patients was respectively 13.3% (95% CI 7.4-22.8%), 15.9% (5.6-37.6%) and 0.5% (0.3-0.6%). The pooled SIRs for a subsequent BCC, SCC or melanoma were respectively 17.4 (95% CI 0.0-37.4), 3.2 (0.0-6.5) and 2.4 (2.3-2.6) in BCC and 4.2 (95% CI 2.0-6.5), 15.0 (14.0-16.0) and 2.7 (2.3-3.2) in SCC patients. In the subgroup analyses, strongest differences in risks were found in the continent strata (risks Australia>North America>Europe).
在这项系统评价和荟萃分析中，研究了既往角化细胞癌（KC）患者发生基底细胞癌（BCC）、鳞状细胞癌（SCC）或黑色素瘤的风险。检索了 PubMed、Embase、Web of Science 和 Cochrane 图书馆，以查找截至 2012 年 1 月 1 日之前发表的报告先前 KC 患者发生后续 BCC、SCC 或黑色素瘤风险（即比例、累积风险或标准化发病比[SIR]）的研究。有 45 篇文章符合纳入标准。在 BCC 患者中，后续 BCC、SCC 或黑色素瘤的合并比例分别为 29.2%（95%置信区间[CI] 24.6-34.3%）、4.3%（1.7-10.1%）和 0.5%（0.4-0.8%）。SCC 患者中后续 SCC、BCC 或黑色素瘤的合并比例分别为 13.3%（95% CI 7.4-22.8%）、15.9%（5.6-37.6%）和 0.5%（0.3-0.6%）。BCC 和 SCC 患者后续 BCC、SCC 或黑色素瘤的 SIR 分别为 17.4（95% CI 0.0-37.4）、3.2（0.0-6.5）和 2.4（2.3-2.6）和 4.2（95% CI 2.0-6.5）、15.0（14.0-16.0）和 2.7（2.3-3.2）。在亚组分析中，在大陆分层中发现风险差异最大（澳大利亚>北美>欧洲）。
