School of Medicine & Dentistry, Griffith University, Gold Coast, Queensland, Australia.
Department of Nephrology, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia.
Nephrology (Carlton). 2021 Nov;26(11):907-919. doi: 10.1111/nep.13939. Epub 2021 Jul 28.
With an increasing number of renal transplant recipients (RTRs) and improving patient survival, a higher incidence of non-melanoma skin cancer (NMSC) has been observed. NMSC in RTRs are often more numerous and biologically more aggressive than the general population, thus contributing towards an increase in morbidity and to a lesser degree, mortality. The resultant cumulative health and financial burden is a recognized concern. Proposed strategies in mitigating risks of developing NMSC and early therapeutic options thereof include tailored modification of immunosuppressants in conjunction with sun protection in all transplant patients. This review highlights the clinical and financial burden of transplant-associated skin cancers, carcinogenic mechanisms in association with immunosuppression, importance of skin cancer awareness campaign and integrated transplant skin clinic, and the potential role of chemoprotective agents. A scheme is proposed for primary and secondary prevention of NMSC based on the available evidence.
随着肾移植受者（RTR）数量的增加和患者生存率的提高，观察到非黑色素瘤皮肤癌（NMSC）的发病率更高。RTR 中的 NMSC 通常比一般人群数量更多且生物学侵袭性更强，因此导致发病率增加，在较小程度上导致死亡率增加。由此产生的累积健康和经济负担是一个公认的问题。减轻 NMSC 发病风险和早期治疗选择的建议策略包括对所有移植患者联合使用免疫抑制剂进行量身定制的调整，以及防晒措施。本综述强调了与移植相关的皮肤癌的临床和经济负担、与免疫抑制相关的致癌机制、皮肤癌意识运动和综合移植皮肤诊所的重要性，以及化学预防剂的潜在作用。根据现有证据，提出了 NMSC 的一级和二级预防方案。
