Department of Dermatology, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Universidad del Desarrollo-Clínica Alemana, Santiago, Chile.
Department of Dermatology, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Universidad del Desarrollo-Clínica Alemana, Santiago, Chile.
Crit Rev Oncol Hematol. 2022 Sep;177:103754. doi: 10.1016/j.critrevonc.2022.103754. Epub 2022 Jul 5.
This review outlines our current understanding of the relationship between immunosuppression and skin cancer. Primary immunodeficiencies increase the incidence of skin cancer, but due to their low frequency, the establishment of accurate risk ratios remains lacking. Regarding secondary immunosuppression, available data demonstrate a significant increase of skin cancer in solid organ recipients, being the most common malignancy of this population. Immunosuppressive drugs have an important role in these patients, with an impact related to both the cumulative dose and the type of regimen used. The association of skin cancer and immunosuppressive drugs in non-transplant patients is conflictive for most of the drugs except for azathioprine. Many cancers lead to secondary immunosuppression as a mechanism for tumor growth and advancement, increasing the risk of progression of the primary tumor. Novel insights related with tumorigenesis and immune-escape mechanisms have led to promising new treatments in melanoma and squamous cell carcinoma.
本文概述了我们目前对免疫抑制与皮肤癌之间关系的理解。原发性免疫缺陷会增加皮肤癌的发病率，但由于其发病率较低，因此仍缺乏准确的风险比。至于继发性免疫抑制，现有数据表明实体器官受者的皮肤癌发病率显著增加，这是该人群中最常见的恶性肿瘤。免疫抑制剂在这些患者中具有重要作用，其影响与累积剂量和所用方案类型有关。除了硫唑嘌呤外，大多数药物的皮肤癌和免疫抑制剂在非移植患者中的相关性存在争议。许多癌症会导致继发性免疫抑制，作为肿瘤生长和进展的机制，增加了原发性肿瘤进展的风险。与肿瘤发生和免疫逃逸机制相关的新见解为黑色素瘤和鳞状细胞癌的新治疗方法带来了希望。
