Krásová Martina, Sečníková Zuzana, Göpfertová Dana, Hercogová Jana, Viklický Ondřej, Jůzlová Kateřina, Jiráková Anna, Šmerhovský Zdeněk
Dermatology Department, 2nd Medical Faculty, Charles University in Prague and Bulovka Hospital.
Institute of Epidemiology, 2nd Medical Faculty, Charles University in Prague.
Dermatol Ther. 2016 Nov;29(6):433-436. doi: 10.1111/dth.12379. Epub 2016 Jun 21.
To determine the incidence of malignancies in renal transplant recipients (RTRs) and to analyze the association between the risk of skin cancer and immunosuppressive regiments used in the posttransplant period.
A cohort study was performed on 797 RTRs. Standardized morbidity ratio (SMR) was calculated for the most common types of cancer developed in the posttransplant period and different types of immunosuppressive therapy used in the cohort.
192 cases of malignancies were diagnosed in 86 RTRs (10.8%). Nonmelanoma skin cancer (NMSC) was the most frequent type of cancer (SMR = 6.42, p = 0.000), followed by renal cancer (SMR = 5.9, p = 0.000), malignant melanoma (SMR = 2.59, p = 0.080), and prostate cancer (SMR = 1.21, p = 0.593). The risk to develop NMSC was significantly higher in the group where cyclosporine has been used besides tacrolimus, mycophenolatemophetil and steroids as well as in the group treated with the combination without cyclosporine (SMR = 9.62, p = 0.001 and SMR = 5.18, p = 0.000). Furthermore, the risk was significantly higher in RTRs receiving anti-thymocyte globulin within induction therapy (SMR = 4.14, p = 0.000).
The preliminary results indicate that the risk of NMSC in RTRs is significantly higher than in the general population and thus emphasize the need to improve preventive strategies in the Czech transplant population.
确定肾移植受者（RTRs）中恶性肿瘤的发病率，并分析皮肤癌风险与移植后使用的免疫抑制方案之间的关联。
对797名RTRs进行了队列研究。计算了移植后发生的最常见癌症类型以及队列中使用的不同类型免疫抑制治疗的标准化发病比（SMR）。
86名RTRs中诊断出192例恶性肿瘤（10.8%）。非黑色素瘤皮肤癌（NMSC）是最常见的癌症类型（SMR = 6.42，p = 0.000），其次是肾癌（SMR = 5.9，p = 0.000）、恶性黑色素瘤（SMR = 2.59，p = 0.080）和前列腺癌（SMR = 1.21，p = 0.593）。在除他克莫司、霉酚酸酯和类固醇外还使用环孢素的组以及未使用环孢素的联合治疗组中，发生NMSC的风险显著更高（SMR = 9.62，p = 0.001和SMR = 5.18，p = 0.000）。此外，在诱导治疗中接受抗胸腺细胞球蛋白的RTRs中风险显著更高（SMR = 4.14，p = 0.000）。
初步结果表明，RTRs中NMSC 的风险显著高于一般人群，因此强调了在捷克移植人群中改进预防策略的必要性。
