SELF-REPORTS OF MOLE COUNTS AND CUTANEOUS MALIGNANT-MELANOMA IN WOMEN - METHODOLOGICAL ISSUES AND RISK OF DISEASE
SELF-REPORTS OF MOLE COUNTS AND CUTANEOUS MALIGNANT-MELANOMA IN WOMEN - METHODOLOGICAL ISSUES AND RISK OF DISEASE
复制标题
DOI：
10.1093/oxfordjournals.aje.a114851
复制
发表时间：
1988-04-01
影响因子：
5
通讯作者：
SPEIZER, FE
中科院分区：
文献类型：
--
作者：
BAIN, C;COLDITZ, GA;SPEIZER, FE
在98例诊断时年龄在32-59岁的发病病例和190例来自护士健康研究的年龄匹配对照中，探讨了四肢上存在痣（痣）与皮肤恶性黑色素瘤风险的关系，护士健康研究是美国女性护士的前瞻性队列。本研究包括1976年至1982年随访期间诊断的病例。参与者在邮寄问卷中报告了所有痣和单独的痣。病例组和对照组的上下肢右侧和左侧痣的分布相似。所有妇女的计数都随着年龄的增长而下降，从最年轻的三分之一对照组（36-46岁）的中位数15下降到最年长的三分之一对照组（54-62岁）的中位数3。病例组比对照组有更多的痣（所有四肢上的总痣的中位数分别为23和9）：患黑色素瘤的相对风险从2.2（95%置信区间（CI）= 1.2-4.0），对于一个或多个痣的手臂上的2.9（95% CI = 1.6-5.3），对于一个或多个痣的下肢。对于隆起的痣，手臂的相对危险度为1.7（95% CI = 1.0-2.7），下肢为2.1（95% CI = 1.3-3.5），腿部（膝盖以下）为3.5（95% CI = 2.0-6.3）。最高的特定地点风险（即，与黑色素瘤相同肢体上的任何痣与该肢体上没有痣）是下肢上的痣（相对风险= 5.0（95%CI = 1.8-13.5））。当考虑绝对痣数时，随着所有肢体上痣数的增加，总体和部位特异性风险有积极和显著的趋势，例如，对于四肢上的痣总数，对于趋势= 4.0，单侧p < 0.001，大于100摩尔的相对风险为6.0。在logistic回归分析中纳入阳光照射和其他体质因素并没有改变这些观察到的痣的存在和黑色素瘤风险之间的关系。
The relation of the presence of moles (nevi) on all four limbs to risk of cutaneous malignant melanoma was explored among 98 incident cases aged 32-59 years at diagnosis and 190 age-matched controls drawn from the Nurses'' Health Study, a prospective cohort of female nurses in the United States. Cases diagnosed during follow-up from 1976 to 1982 were included in this study. Participants reported counts of all moles and raised moles alone on postal questionnaires. Distributions of moles were similar for right and left sides on upper and lower limbs for cases and controls. Counts declined with increasing age for all women, from a median of 15 for the youngest tertile of controls (aged 36-46 years) to three for the oldest (aged 54-62 years). Cases had more moles than did controls (medians of 23 and 9, respectively, for total moles on all four limbs): The presence of any mole on a limb gave relative risks for melanoma ranging from 2.2 (95% confidence interval (Cl) = 1.2-4.0) for one or more moles on an arm to 2.9 (95% Cl = 1.6-5.3) for one or more moles on the lower limb. For raised moles, relative risks were 1.7 (95% Cl = 1.0-2.7) for arm, 2.1 (95% Cl = 1.3-3.5) for lower limb, and 3.5 (95% Cl = 2.0-6.3) for leg (below knee). The highest site-specific risk (i.e., for any moles on the same limb as the melanoma vs. no moles on that limb) was for moles on the lower limb (relative risk = 5.0 (95% Cl = 1.8-13.5)). There were positive and significant trends in overall and site-specific risk with increasing numbers of moles on all limbs when absolute mole counts were considered, e.g., for total moles on all four limbs combined, .chi. for trend = 4.0, one-sided p < 0.001, with relative risk for more than 100 moles versus none of 6.0. Inclusion of sun exposure and other constitutional factors in logistic regression analyses did not alter these observed relations between the presence of moles and risk of melanoma.