Skin cancer and solar UV radiation
Skin cancer and solar UV radiation
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DOI：
10.1016/s0959-8049(99)00283-x
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发表时间：
1999-12-01
影响因子：
8.4
通讯作者：
de Gruijl, FR
中科院分区：
文献类型：
--
作者：
de Gruijl, FR
阳光中的紫外线辐射是我们自然环境中最突出和最普遍的物理致癌物。它具有高度的遗传毒性，但不会渗透到皮肤以外的任何深处。像所有经常暴露在阳光下的生物一样，人类皮肤非常适应持续的紫外线压力。蹼状色素沉着的皮肤显然比白色高加索人的皮肤更好地保护。发达国家的白色高加索人寻求阳光的习惯可能是导致上个世纪皮肤癌增加的主要原因。皮肤癌是目前为止美国和澳大利亚最常见的癌症类型，这似乎是由于对阳光敏感的皮肤的人“非自然位移”到亚热带地区的结果。虽然宣传活动在向人们宣传阳光照射的风险方面取得了成功，但一般的态度和行为似乎尚未改变到足以扭转皮肤癌发病率趋势和相应的公共保健负担的程度。皮肤癌和经常暴露在阳光下之间的关系在19世纪后期就被医生怀疑，随后在20世纪早期的动物实验中得到证实。紫外线辐射被发现具有高度的遗传毒性，DNA修复被证明在抵御诱变和细胞死亡等有害影响方面至关重要。事实上，在1940年左右，人们发现致突变性的波长依赖性超过了DNA的紫外吸收。在1970年代，人们对平流层臭氧层今后可能消耗的关注，推动了对紫外线致癌作用的研究：由此造成的环境紫外线负荷的增加，预计会增加皮肤癌的发病率。世纪最后几十年的流行病学研究极大地完善了我们对皮肤癌病因学的认识。对皮肤癌基因突变的分析表明，紫外线辐射是原因。然而，最致命的皮肤癌，即恶性黑色素瘤和太阳紫外线暴露之间的关系仍然不清楚，需要澄清，以优化预防措施，最大限度地减少皮肤癌的死亡率。(C)1999 Elsevier Science Ltd.保留所有权利。
Ultraviolet (UV) radiation in sunlight is the most prominent and ubiquitous physical carcinogen in our natural environment. It is highly genotoxic but does not penetrate the body any deeper than the skin. Like all organisms regularly exposed to sunlight, the human skin is extremely well adapted to continuous UV stress. Web-pigmented skin is clearly better protected than white Caucasian skin. The sun-seeking habits of white Caucasians in developed countries are likely to have contributed strongly to the increase in skin cancer observed over the last century. Skin cancer is by far the most common type of cancer in the U.S.A. and Australia, which appears to be the result of an 'unnatural displacement' of people with sun-sensitive skin to sub-tropical regions. Although campaigns have been successful in informing people about the risks of sun exposure, general attitudes and behaviour do not yet appear to have changed to the extent that trends in skin cancer morbidity and the corresponding burden on public healthcare will be reversed. The relationship between skin cancer and regular sun exposure was suspected by physicians in the late 19th century, and subsequently substantiated in animal experiments in the early part of the 20th century. UV radiation was found to be highly genotoxic, and DNA repair proved to be crucial in fending off detrimental effects such as mutagenesis and cell death. In fact, around 1940 it was shown that the wavelength dependence of mutagenicity paralleled the UV absorption by DNA. In the 1970s research on UV carcinogenesis received a new impetus from the arising concern about a possible future depletion of the stratospheric ozone layer: the resulting increases in ambient UV loads were expected to raise skin cancer incidences. Epidemiological studies in the last decades of the 20th century have greatly refined our knowledge on the aetiology of skin cancers. Analyses of gene mutations in skin carcinomas leave identified UV radiation as the cause. The relationship between the most fatal skin cancer, i.e. malignant melanoma and solar UV exposure is, however, still unclear and needs to be clarified to optimise preventive measures and minimise mortality from skin cancers. (C) 1999 Elsevier Science Ltd. All rights reserved.