Incidence of skin cancer in 5356 patients following organ transplantation
Incidence of skin cancer in 5356 patients following organ transplantation
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DOI：
10.1046/j.1365-2133.2000.03703.x
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发表时间：
2000-09-01
影响因子：
10.3
通讯作者：
Stern, RS
中科院分区：
文献类型：
--
作者：
Lindelöf, B;Sigurgeirsson, B;Stern, RS
固体器官移植后背景皮肤癌是长期幸存者发病率的重要原因。这种风险是众所周知的，但已被量化了不可行的。我们旨在确定：（i）移植患者的皮肤癌风险更精确； （ii）是否改变了恶性黑色素瘤的风险：（iii）在非暴露部位发生上皮癌的风险是否与暴露于阳光的场所相媲美。在1970年至1994年之间在瑞典接受了强制性瑞典癌症注册表的器官移植的人，以识别除基础细胞以外的所有癌症病例癌，未注册。在平均随访5后，反应。移植后6年，5356例患者中有172名患者患有325例非黑色素瘤皮肤癌（不包括基底细胞癌）和6种恶性黑色素瘤。非黑色素瘤皮肤癌的相对风险为108。 6 [95％置信区间（CI）94。 6-123。 1]对于男人和92。 8（95％CI73。2-116。0）女性。上肢的风险最高，随着时间的流逝，风险增加。没有注意到恶性黑色素瘤的显着增加：相对风险为1。 6（95％CI0。5-3。7）男性和0。 5（95％CI0。0.0-2。6）女性，除了嘴唇（也暴露于阳光）外，其他上皮部位没有显示出癌症风险的可比性增加。判断我们得出结论，例如，器官移植受者处于非甲状腺瘤皮肤癌的风险高度增加，一生中必须紧随其后。阳光暴露与移植相关的癌症风险高于非阳性暴露的上皮组织，即使是生活在太阳能降低的地区的人群中。
Background Skin cancer following solid organ transplantation is an important cause of morbidity in long-term survivors. This risk is well known but imprecisely quantified.Objectives We aimed to determine: (i) the skin cancer risks in transplant patients more precisely; (ii) whether the risk of malignant melanoma is altered: and (iii) whether the risk of epithelial cancers occurring at non-exposed sites is comparable with that seen in sun-exposed sites.Methods We linked a population-based cohort of 5356 patients who had received organ transplants in Sweden between 1970 and 1994 with the compulsory Swedish Cancer Registry, to identify all cancer cases except basal cell carcinomas, which are not registered.Results After a mean follow-up of 5 . 6 years post-transplantation, 172 of 5356 patients developed 325 non-melanoma skin cancers (excluding basal cell carcinomas) and six malignant melanomas. The relative risk of non-melanoma skin cancer was 108 . 6 [95% confidence interval (CI) 94 . 6-123 . 1] for men and 92 . 8 (95% CI 73 . 2-116 . 0) for women. The highest risks were noted for upper limbs, and the risk increased with time. No significant increase in malignant melanomas was noted: the relative risk was 1 . 6 (95% CI 0 . 5-3 . 7) for men and 0 . 5 (95% CI 0 . 0-2 . 6) for women, Except for the lip, which is also sun-exposed, other epithelial sites did not show comparable increases in cancer risk.Conclusions We conclude that organ transplant recipients are at a highly increased risk for nonmelanoma skin cancer and must be closely followed throughout their lives. Cancer risk associated with transplantation is higher for sun-exposed than for non-sun-exposed epithelial tissues, even among populations living in regions with low solar insolation.