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接受口服免疫抑制药物治疗的特应性皮炎患者发生非黑素瘤皮肤癌的风险。

Risk of Non-melanoma Skin Cancer in Patients with Atopic Dermatitis Treated with Oral Immunosuppressive Drugs.

作者信息

Garritsen Floor M, van der Schaft Jorien, van den Reek Juul M, Politiek Klaziena, van Os-Medendorp Harmieke, van Dijk Marijke, Hijnen Dirk J, de Graaf Marlies, Bruijnzeel-Koomen Carla A, de Jong Elke M, Schuttelaar Marie-Louise A, Bruin-Weller Marjolein S

机构信息

Department of Dermatology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.

出版信息

Acta Derm Venereol. 2017 Jun 9;97(6):724-730. doi: 10.2340/00015555-2637.

Abstract

There is uncertainty about the risk of developing non-melanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma (SCC), in patients with atopic dermatitis (AD) treated with oral immunosuppressive drugs. A total of 557 patients with AD treated with these drugs in the University Medical Center Utrecht and Groningen, the Netherlands, were analysed. NMSC after oral immunosuppressive treatment was reported in 18 patients (3.2%). The standardized incidence ratio for developing SCC was 13.1 (95% confidence interval (95% CI) 6.5-19.7). Patients developing NMSC were older at the start of therapy (p<0.001) and data lock (p<0.001) compared with patients without NMSC. No significant differences were found in sex, cumulative days of oral immunosuppressive drugs and follow-up between these groups (p=0.42, p=0.88, and p=0.34, respectively). In interpreting these results it is important to include other factors, such as lack of association between treatment duration and tumour development and the long interval between treatment discontinuation and tumour development in some patients.

摘要

对于接受口服免疫抑制药物治疗的特应性皮炎(AD)患者,发生非黑素瘤皮肤癌(NMSC,包括基底细胞癌和鳞状细胞癌(SCC))的风险存在不确定性。对荷兰乌得勒支大学医学中心和格罗宁根大学共557例接受这些药物治疗的AD患者进行了分析。18例患者(3.2%)报告在口服免疫抑制治疗后发生了NMSC。发生SCC的标准化发病率比为13.1(95%置信区间(95%CI)6.5 - 19.7)。与未发生NMSC的患者相比,发生NMSC的患者在治疗开始时(p<0.001)和数据锁定时(p<0.001)年龄更大。这些组在性别、口服免疫抑制药物的累积天数和随访方面未发现显著差异(分别为p = 0.42、p = 0.88和p = 0.34)。在解释这些结果时,纳入其他因素很重要,例如治疗持续时间与肿瘤发生之间缺乏关联,以及一些患者在停止治疗与肿瘤发生之间的间隔时间较长。

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