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肝移植术后新发皮肤肿瘤:105 例单中心前瞻性评估。

De Novo Skin Neoplasms in Liver-Transplanted Patients: Single-Center Prospective Evaluation of 105 Cases.

机构信息

Clinical and Experimental Medicine Ph.D. Program, University of Modena and Reggio Emilia, 41124 Modena, Italy.

Dermatology Unit, Modena University Hospital, University of Modena and Reggio Emilia, 41124 Modena, Italy.

出版信息

Medicina (Kaunas). 2022 Oct 13;58(10):1444. doi: 10.3390/medicina58101444.

Abstract

: Solid-organ transplant recipients (SOTRs) are notably considered at risk for developing cutaneous malignancies. However, most of the existing literature is focused on kidney transplant-related non-melanoma skin cancers (NMSCs). Conflicting data have been published so far on NMSC incidence among liver transplant recipients (LTRs), and whether LTRs really should be considered at lower risk remains controversial. The aim of the present study was to prospectively collect data on the incidence of cutaneous neoplasms in an LTR cohort. All LTRs transplanted at the Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit of Modena University Hospital from October 2015 to June 2021 underwent a post-transplant periodic skin check at the Dermatology Unit according to our institutional integrated care pathway. Data on the presence of cutaneous malignant and premalignant lesions were collected at every timepoint. A total of 105 patients were enrolled in the present study. Nearly 15% of the patients developed cutaneous cancerous and/or precancerous lesions during the follow-up period. Almost half of the skin cancerous lesions were basal cell carcinomas. Actinic keratoses (AKs) were observed in six patients. Four patients developed in situ squamous cell carcinomas, and one patient was diagnosed with stage I malignant melanoma. Otherwise, well-established risk factors for the occurrence of skin tumors, such as skin phototype, cumulative sun exposure, and familial history of cutaneous neoplasms, seemed to have no direct impact on skin cancer occurrence in our cohort, as well as an immunosuppressive regimen and the occurrence of non-cutaneous neoplasms. : Close dermatological follow-up is crucial for LTRs, and shared protocols of regular skin checks in this particular subset of patients are needed in transplant centers.

摘要

实体器官移植受者(SOTR)被认为存在发生皮肤恶性肿瘤的风险。然而,大多数现有文献主要集中在与肾移植相关的非黑色素瘤皮肤癌(NMSC)上。到目前为止,关于肝移植受者(LTR)中 NMSC 的发病率已经发表了相互矛盾的数据,LTR 是否真的应该被认为风险较低仍存在争议。本研究的目的是前瞻性地收集 LTR 队列中皮肤肿瘤发病率的数据。

自 2015 年 10 月至 2021 年 6 月,摩德纳大学医院肝胆胰外科和肝移植科移植的所有 LTR 都根据我们的机构综合护理途径在皮肤科接受移植后定期皮肤检查。每次都收集有关皮肤恶性和癌前病变存在的数据。

本研究共纳入 105 例患者。在随访期间,近 15%的患者出现皮肤癌性和/或癌前病变。几乎一半的皮肤癌病变为基底细胞癌。在 6 例患者中观察到光化性角化病(AK)。4 例患者发展为原位鳞状细胞癌,1 例患者被诊断为 I 期恶性黑色素瘤。此外,皮肤肿瘤发生的既定危险因素,如皮肤光型、累积日光暴露和皮肤肿瘤家族史,似乎对我们队列中皮肤癌的发生没有直接影响,免疫抑制方案和非皮肤肿瘤的发生也没有直接影响。

密切的皮肤科随访对 LTR 至关重要,移植中心需要为这一特定患者群体制定定期皮肤检查的共享方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/411e/9610576/f56f90860cc8/medicina-58-01444-g001.jpg

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