Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Dermatology, University of California at San Francisco, San Francisco, California.
Division of Research, Kaiser Permanente Northern California, Oakland, California.
J Am Acad Dermatol. 2014 Sep;71(3):521-8. doi: 10.1016/j.jaad.2014.04.019. Epub 2014 May 21.
Patients with melanoma are at increased risk for cutaneous squamous cell carcinomas (SCCs).
We sought to examine the incidence of subsequent SCC among melanoma survivors and the impact of patient and melanoma characteristics on SCC risk.
Kaiser Permanente Northern California members given the diagnosis of melanoma from 2000 to 2005 (n = 6378) were followed up through 2009 for a pathology-confirmed SCC. Cox models were used to estimate SCC risk.
The crude SCC incidence rate was 2.41 per 100 person-years, and was higher among males and older subjects. In adjusted models stratified by age, SCC risk was higher among males (hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.22-1.67), those with history of nonmelanoma skin cancer (HR 2.56, 95% CI 2.19-2.98), and those with higher tumor sequence numbers (HR 1.35, 95% CI 1.01-1.80). SCC risk was lower among non-Hispanic whites (HR 0.39, 95% CI 0.17-0.86).
SCC risk was not examined among members without melanoma.
SCCs arise in approximately 12% of patients with melanoma over a 5-year period and are more common among males, whites, patients older than 60 years, those with prior reportable cancers, and those with history of nonmelanoma skin cancer. Clinicians should be vigilant for SCCs among these individuals at high risk, and counsel melanoma survivors about their increased risk for SCCs.
黑色素瘤患者罹患皮肤鳞状细胞癌（SCC）的风险增加。
我们旨在研究黑色素瘤幸存者中 SCC 的发生率，以及患者和黑色素瘤特征对 SCC 风险的影响。
Kaiser Permanente Northern California 机构的成员在 2000 年至 2005 年间被诊断为黑色素瘤（n=6378），并在 2009 年前进行了经病理证实的 SCC 随访。Cox 模型用于估计 SCC 风险。
未经调整的 SCC 发病率为 2.41/100 人年，男性和年龄较大的患者发病率更高。在按年龄分层的调整模型中，男性 SCC 风险更高（风险比 [HR] 1.43，95%置信区间 [CI] 1.22-1.67），有非黑色素瘤皮肤癌病史者（HR 2.56，95% CI 2.19-2.98），以及肿瘤序列数较高者（HR 1.35，95% CI 1.01-1.80）。非西班牙裔白人 SCC 风险较低（HR 0.39，95% CI 0.17-0.86）。
没有黑色素瘤的成员中没有检查 SCC 风险。
在 5 年内，约 12%的黑色素瘤患者会发生 SCC，男性、白人、年龄大于 60 岁、有既往报告癌症史和非黑色素瘤皮肤癌病史的患者更为常见。临床医生应警惕这些高危人群中 SCC 的发生，并向黑色素瘤幸存者提供有关 SCC 风险增加的咨询。
