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Level of UV Exposure, Skin Type, and Age Are More Important than Thiopurine Use for Keratinocyte Carcinoma Development in IBD Patients.

在IBD患者中,紫外线暴露水平、皮肤类型和年龄对于角质形成细胞癌的发展比使用硫嘌呤更重要。

  • 影响因子:2.46
  • DOI:10.1007/s10620-019-05818-w
  • 作者列表:"Wu Y","Ghaly S","Kerr S","Jackson B","Hanigan K","Martins D","Krishnaprasad K","Mountifield RE","Whiteman DC","Bampton PA","Gearry RB","Radford-Smith GL","Lawrance IC
  • 发表时间:2020-04-01
Abstract

BACKGROUND:Retrospective studies observe an increased risk of keratinocyte carcinomas (KCs) in patients with inflammatory bowel disease (IBD) on thiopurine (TP) medication. The role of traditional risk factors such as skin type and sun protection behavior has not been studied in this population. This study aimed to examine traditional KC risk factors and thiopurine use on skin cancer development in an IBD cohort. METHODS:Consecutive IBD patients were recruited from four specialist centers in Australia and New Zealand, each with varying UV exposure indices. Data pertaining to race, skin color, freckling and sun protection behavior, dose of TP therapy, and skin cancer development were elicited through a self-reported questionnaire. RESULTS:A total of 691 IBD patients were included with 62 reporting KC development. Thiopurine usage was similar among patients who developed skin cancer compared with those who did not (92% vs. 89%, p = 0.3). There was no statistically significant association between KC development and TP dose or 6-thioguanine nucleotide levels. In multivariate modeling, four factors were independently and significantly associated with KC: age over 61 years old versus less than 30 years old (OR 6.76; 95% CI 2.38-19.18), residing in Brisbane versus Christchurch (OR 3.3; 95% CI 1.6-6.8), never staying in the shade versus staying in the shade ≥ 50% of the time (OR 3.8; 95% CI 1.4-10.5), and having a skin type that never tanned versus other skin types (OR 6.9; 95% CI 2.9-16.0). CONCLUSION:Skin type, age, and sun protection behavior are more important risk factors for KC development than thiopurine medication use in this IBD population.

摘要

背景: 回顾性研究观察到使用硫嘌呤 (TP) 药物治疗的炎症性肠病 (IBD) 患者发生角质形成细胞癌 (KCs) 的风险增加。皮肤类型和防晒行为等传统风险因素的作用尚未在该人群中进行研究。本研究旨在研究IBD队列中传统的KC风险因素和硫嘌呤的使用对皮肤癌发展的影响。 方法: 从澳大利亚和新西兰的四个专科中心招募连续的IBD患者,每个中心具有不同的紫外线暴露指数。关于种族、肤色、雀斑和防晒行为、TP治疗剂量和皮肤癌发展的数据通过自我报告的问卷得出。 结果: 共纳入691例IBD患者,其中62例报告了KC的发生。发生皮肤癌的患者与未发生皮肤癌的患者相比,硫嘌呤的使用情况相似 (92% 对89%,p = 0.3)。KC发育与TP剂量或6-硫鸟嘌呤核苷酸水平之间没有统计学上显著的关联。在多变量模型中,四个因素与KC独立且显著相关: 年龄超过61岁与小于30岁 (OR 6.76; 95% CI 2.38-19.18),居住在布里斯班与克赖斯特彻奇 (OR 3.3; 95% CI 1.6-6.8),从不呆在阴凉处与呆在阴凉处 ≥ 50% 的时间 (OR 3.8; 95% CI 1.4-10.5),并且具有从未晒黑的皮肤类型与其他皮肤类型 (OR 6.9; 95% CI 2.9-16.0)。 结论: 在该IBD人群中,皮肤类型、年龄和防晒行为是KC发展比硫嘌呤类药物使用更重要的危险因素。

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影响因子:2.93
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DOI:10.1016/j.jaad.2019.04.067
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影响因子:0.96
发表时间:2020-01-01
DOI:10.1097/DAD.0000000000001459
作者列表:["Lang UE","Love NR","Cheung C","McCalmont TH","Kim J"]

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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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