腎臟移植接受者身上的皮膚惡性腫瘤之研究－南台灣的經驗

The Study of Cutaneous Malignancies in Renal Transplant Recipients-Southern Taiwan Experience

馮文瑋(Wen-Wei Feng) ； 何宜承(Ji-Chen Ho) ； 莊昭華(Chao-Hua Chuang) ； 謝輝和(Hwai-Ho Hsieh)

《中華皮膚科醫學雜誌》 20卷3期 (2002/09) Pp. 169-179

摘要

在西方國家研究中，皮膚癌是腎臟移植接受者中最常見的惡性腫瘤，但是在台灣的相關資料卻十分有限。在這個歷史性世代流行病學研究裡，我們探討按台灣286個腎藏移植接受者的癌症發生狀況。在286個腎移植接受者中，有16個罹患惡性腫瘤。南台灣腎臟移植接受身上所發生之惡性腫瘤分布與他國不同：泌尿系統癌為最常見者。卡波西氏肉瘤有二例。皮膚淋巴瘤有一例，但沒有發現鱗狀細胞癌或基底細胞癌。女性和腎臟移植時的年齡較高是致癌的危險因子。在這裡首次報告腎臟移植後發生卡被西氏肉瘤和皮膚淋巴瘤的台灣病例，長期使用免疫抑制劑可能是主因。臨床醫師使用免疫抑制劑時仍需注意其致癌的併發症。

並列摘要

Skin cancer is the most common cancer among renal-transplant recipients in Western studies, but in
Taiwan the related information appears limited. We studied a population-based cohort of 286 renal-
transplant recipients in southern Taiwan between 1981 and 1999, in order to identify the incidence and
distribution of cancers. Sixteen of the 286 renal-transplant recipients developed malignancies. The
distribution of malignancies deriving from renal transplant recipients in southern Taiwan appears to be
totally different from that in Western countries. The most common type of cancer in our study was
bladder cancer, and two patients experienced Kapposi’s sarcoma, and one revealed lymphoma cutis,
although there were no cases of either squamous-cell carcinoma or basal-cell carcinoma. Being female
and being older rather than younger at time of renal transplantation appear to be the only two risk factors
for malignancy formation. Here we first report Kaposi’s sarcoma and lymphoma cutis in renal transplant
recipients in Taiwan. The incidence may be associated with long-term use of immunosuppressive agents
very strongly. Clinicians should continually be on guard in order to be alert for the potential oncogenic
complications of immunosuppressive agents.

並列關鍵字

Malignancy ； Skin ； Incidence ； Renal transplantation ； Immunosuppressive agent