Clinicopathologic features of skin cancer in organ transplant recipients: A retrospective case-control series
Clinicopathologic features of skin cancer in organ transplant recipients: A retrospective case-control series
复制标题
DOI：
10.1016/j.jaad.2005.10.049
复制
发表时间：
2006-02-01
影响因子：
13.8
通讯作者：
Cerio, R
中科院分区：
文献类型：
--
作者：
Harwood, CA;Proby, CM;Cerio, R
背景资料：非黑色素瘤皮肤癌（NMSC）在器官移植受者中增加，但移植和免疫活性鳞状细胞癌和基底细胞癌（SCC，BCC）以前没有在单中心研究中进行比较。目的：比较移植和免疫活性NMSCs的临床病理特征。连续移植NMSCs（60个SCC，100个BCC）和免疫活性NMSC 1995- 1997年共收治SCC 40例，BCC 125例。与免疫功能正常的个体相比，移植患者在NMSC诊断时年轻15岁，并且移植肿瘤通常是多发性的和脑外的。梭形细胞形态在移植SCC中更常见，浅表成分在移植BCC中更常见，HPV感染的组织学特征在移植肿瘤中过度表达。移植SCC的结果更糟，但不是移植BCCs.Limitations：组织学特征需要识别HPV感染尚未被valided.Conclusions：这些研究结果有直接的影响，为临床护理。移植NMSC的频率和分布的增加强调了全身监测的重要性。移植SCC，特别是那些弥漫性梭形细胞变化，可能需要更积极的管理，而移植BCC不需要。最后，我们的数据支持移植NMSC发病机制的差异，这可能会影响未来的预防和治疗策略。
Background: Non-melanoma skin cancers (NMSCs) are increased in organ transplant recipients, but transplant and immunocompetent squamous and basal cell carcinomas (SCCs, BCCs) have not been compared previously in a single-center study.Objective: To compare clinicopathologic features of transplant and immunocompetent NMSCs.Methods: Consecutive transplant NMSCs (60 SCCs, 100 BCCs) and immunocompetent NMSCs (40 SCCs, 125 BCCs) presenting between 1995-1997.Results: Transplant patients were 15 years younger at time of NMSC diagnosis compared with immunocompetent individuals, and transplant tumors were often more multiple and extracephalic. Spindle cell morphology was more common in transplant SCCs, a superficial component was more common in transplant BCCs, and histologic features of HPV infection were overrepresented in transplant tumors. Outcome was worse for transplant SCCs but not transplant BCCs.Limitations: Histologic features required to identify HPV infection have not been validated.Conclusions: These findings have direct implications for clinical care. The increased frequency and distribution of transplant NMSCs underscore the importance of whole-body surveillance. Transplant SCCs, particularly those with diffuse spindle cell change, may require more aggressive management, whereas transplant BCCs do not. Finally, our data support differences in the pathogenesis of transplant NMSC, which may influence future preventive and therapeutic strategies.