Borges-Costa João, Vasconcelos João Pedro, Travassos Ana Rita, Guerra José, Santana Alice, Weigert André, Sacramento Marques Manuel
Clínica Universitária Dermatológica de Lisboa, Hospital de Santa Maria, Lisboa, Portugal.
Acta Med Port. 2013 Mar-Apr;26(2):123-6. Epub 2013 May 31.
Organ transplanted recipients have a higher risk of non melanoma skin cancer. Our objectives were to determine incidence of skin cancer and search for associations with clinical or demographic factors in a series of kidney transplant recipients.
A prospective study with face-to-face interview of 127 kidney transplant recipients who were observed for the first time during the second half of 2010 and in 2011. All diagnosed skin cancers were confirmed by histopathology. A 5% significance level was used and statistical analysis performed with chi-square, Fisher´s exact test or Mann Whitney test.
The mean age was 53 (s = 12.98) and 67% were males. The mean number of years since the transplant was 8 (s = 4.61) and skin cancer was observed in 16% (20 / 127), with equal number of basaliomas and squamous cell carcinoma. In sun exposed areas, actinic keratoses and viral warts were present in 24% and 8%, respectively. Skin cancer was significantly associated with older age (p = 0.016), longer duration of immunosuppression (p = 0.003) as well as with previous outdoor work (p = 0.049) or actinic keratoses in sun exposed areas (p < 0.001). Present intake of azathioprine (n = 8) was the only medication associated with skin cancer (p = 0.035 in Fisher´s exact test).
Skin cancer incidence is high in our series and education about photoprotection should be given to these patients, as well as regular dermatologic surveillance. This regular follow up improves compliance with photoprotection measures and helps to decrease the incidence of non melanoma skin cancer.
器官移植受者患非黑素瘤皮肤癌的风险更高。我们的目的是确定一系列肾移植受者中皮肤癌的发病率，并寻找其与临床或人口统计学因素之间的关联。
一项前瞻性研究，对2010年下半年及2011年首次接受观察的127名肾移植受者进行面对面访谈。所有诊断出的皮肤癌均经组织病理学证实。采用5%的显著性水平，并用卡方检验、费舍尔精确检验或曼-惠特尼检验进行统计分析。
平均年龄为53岁（标准差=12.98），67%为男性。移植后的平均年数为8年（标准差=4.61），16%（20/127）的患者患皮肤癌，基底细胞癌和鳞状细胞癌的数量相等。在阳光暴露部位，光化性角化病和病毒疣的发生率分别为24%和8%。皮肤癌与年龄较大（p=0.016）、免疫抑制时间较长（p=0.003）以及既往户外工作（p=0.049）或阳光暴露部位的光化性角化病（p<0.001）显著相关。目前服用硫唑嘌呤（n=8）是唯一与皮肤癌相关的药物（费舍尔精确检验中p=0.035）。
在我们的研究系列中皮肤癌发病率较高，应向这些患者提供光防护教育以及定期进行皮肤科监测。这种定期随访可提高对光防护措施的依从性，并有助于降低非黑素瘤皮肤癌的发病率。
