Kim Changhyun, Cheng Joyce, Colegio Oscar R
Yale University School of Medicine, New Haven, CT.
Yale University School of Medicine, New Haven, CT; Departments of Dermatology and Pathology, Yale University School of Medicine, New Haven, CT; Yale Transplant Dermatology Clinic, Department of Dermatology, Yale University School of Medicine, New Haven, CT; Yale-New Haven Transplantation Center, New Haven, CT; Yale Cancer Center, New Haven, CT.
Semin Oncol. 2016 Jun;43(3):390-4. doi: 10.1053/j.seminoncol.2016.02.019. Epub 2016 Feb 23.
The incidence of cutaneous squamous cell carcinomas (SCCs) in immunosuppressed solid organ transplant recipients (SOTRs) is 65- to 250-fold greater than in the general population. In addition, SCC in SOTRs is more aggressive than in the general population. SOTRs must undergo skin cancer screenings at intervals based on their risk stratification. The incidence of SCC in SOTRs varies with the type, intensity, and duration of the immunosuppressive regimen. Notably, patients on sirolimus have lower incidence of SCC compared to patients on calcineurin inhibitors. Revision of immunosuppressive regimen to include sirolimus may be a viable preventative measure against SCC in SOTRs who are high at risk for developing SCCs. Retinoids are also emerging as a means of chemoprophylaxis against development of new SCCs in high-risk patients. Treatments of SCC include electrodesiccation and curettage, surgical resection, cryosurgery, radiation, and systemic chemotherapy such as 5-fluorouracil and cetuximab.
免疫抑制的实体器官移植受者（SOTR）中皮肤鳞状细胞癌（SCC）的发病率比普通人群高65至250倍。此外，SOTR中的SCC比普通人群中的更具侵袭性。SOTR必须根据其风险分层定期进行皮肤癌筛查。SOTR中SCC的发病率随免疫抑制方案的类型、强度和持续时间而变化。值得注意的是，与使用钙调神经磷酸酶抑制剂的患者相比，使用西罗莫司的患者SCC发病率较低。对于有发生SCC高风险的SOTR，修订免疫抑制方案以纳入西罗莫司可能是预防SCC的一种可行措施。维甲酸也正在成为高危患者预防新SCC发生的一种化学预防手段。SCC的治疗方法包括电干燥刮除术、手术切除、冷冻手术、放射治疗以及全身化疗，如5-氟尿嘧啶和西妥昔单抗。
