Skin cancer in Caucasian renal allograft recipients living in a subtropical climate.
Skin cancer in Caucasian renal allograft recipients living in a subtropical climate.
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生活在亚热带气候下的白种人同种异体肾移植受者的皮肤癌。
作者：
Ian R. Hardie;Ian R. Hardie;Russell W. Strong;Russell W. Strong;Lionel C.J. Hartley;Lionel C.J. Hartley;Peter W.H. Woodruff;Peter W.H. Woodruff;G. Clunie
从1969年9月至1978年12月，290例患者接受了325例尸体肾移植，另外还观察了11例其他地方移植。28名患者（9.3%）发生癌症;其中26名（93%）患有皮肤癌。皮肤癌的发病率在移植物功能恢复第一年后每年增加5%，在移植物功能正常的情况下存活9年的患者中累积增加44%。这表示移植后风险的发生率为4，356/100，000人年--是南昆士兰州一般人群皮肤癌年发生率的20.6倍。在平均潜伏期为34个月后，有一半的患者在首次诊断皮肤癌时患有多发性肿瘤。26名患者共发生138例皮肤癌（平均每名患者5.3例），其中最多19例。基底细胞癌与鳞状细胞癌的比例从一般人群的4：1逆转为1：1.7。传统的手术切除效果满意，与一个局部复发被再次切除控制。两名患者（7%）分别死于黑色素瘤和转移性鳞状细胞癌，而另外四名死于癌症的患者中有两名患有巧合的皮肤癌。这两例皮肤癌死亡仅占同种异体移植受者死亡总数的2%。这些结果表明，这些患者的皮肤癌问题是可以控制的，因此不是临床上继续使用尸体肾移植的明显禁忌症。
Between September, 1969, and December, 1978, 290 patients received 325 cadaveric renal allografts; 11 others transplanted elsewhere were also observed. Cancers developed in 28 patients (9.3%); 26 of these (93%) had skin cancers. The incidence of skin cancer increased by 5% annually after the first year of graft function, to a cumulative 44% in those surviving 9 years with functioning grafts. This represents an incidence of 4,356/100,000 person years of post-transplant risk--20.6 times the annual incidence of skin cancer in the general population of Southern Queensland. Half of the patients had multiple tumors when the first skin cancer was diagnosed, after a mean latent interval of 34 months. A total of 138 skin cancers occurred in 26 patients (average, 5.3 per patient), with a maximum of 19 in one individual. The ratio of basal to squamous cell carcinoma was reversed from 4:1, in the general population, to 1:1.7. Conventional surgical excision gave satisfactory results, with the one local recurrence being controlled by reexcision. Two patients (7%) died of melanoma and metastatic squamous cell carcinoma, respectively, whereas two of the other four patients who died from cancer had coincidental skin cancer. The two skin cancer deaths represent only 2% of all deaths in allograft recipients. These results suggest that the problem of skin cancer in these patients can be controlled and thus is not a significant contraindication to the continued clinical use of cadaveric renal transplantation.