Anatomic site, sun exposure, and risk of cutaneous melanoma
Anatomic site, sun exposure, and risk of cutaneous melanoma
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DOI：
10.1200/jco.2006.06.1325
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发表时间：
2006-07-01
影响因子：
45.3
通讯作者：
Green, Adele C.
中科院分区：
文献类型：
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作者：
Whiteman, David C.;Stickley, Mark;Green, Adele C.
目的日光是皮肤黑色素瘤的主要环境危险因素。目前的一种假说认为，阳光在引起黑色素瘤中的作用根据解剖部位而不同。我们测试了这一假设在一个以人群为基础的病例-病例比较研究的黑色素瘤patients.Methods患者被抽样从昆士兰州癌症登记处在三组：浅表扩散或结节性黑色素瘤的躯干（n = 154），头部和颈部（HN; n = 76），恶性雀斑样痣（LM）和恶性雀斑样痣黑色素瘤（LMM; LM和LM，n 76）。收集了学龄期阳光照射和成年期职业和娱乐阳光照射的数据。结果HN型黑色素瘤患者在成年期比躯干型黑色素瘤患者有更高的日光暴露水平（OR，2.43; 95% CI，0.98至5.99），特别是较高水平的职业暴露（OR，3.25; 95%CI，1.32至8.00），但娱乐性阳光暴露水平较低（OR，0.50; 95%CI，0.21至1.19）。LM和LMM患者报告的职业暴露量高于躯干黑色素瘤患者，娱乐性日光暴露量低于躯干黑色素瘤患者，尽管这并不显著。我们发现学龄期的阳光exposs.Conclusion黑色素瘤发展在不同的身体部位与不同的模式的阳光exposed. Conclusion组之间没有显着差异。头部和颈部的黑色素瘤与慢性阳光照射模式相关，而躯干黑色素瘤与间歇性阳光照射模式相关，支持黑色素瘤可能通过不同的因果途径产生的假设。
Purpose Sunlight is the principal environmental risk factor for cutaneous melanoma. A current hypothesis postulates that the role of sunlight in causing melanoma differs according to anatomic site. We tested this hypothesis in a population-based case-case comparative study of melanoma patients.Methods Patients were sampled from the Queensland cancer registry in three groups: superficial spreading or nodular melanomas of the trunk (n = 154), of the head and neck (HN; n = 76), and lentigo maligna (LM) and lentigo maligna melanoma (LMM; for both LM and LM, n 76). Data were collected on school-age sun exposure and occupational and recreational sun exposure in adulthood. Odds ratios (OR) and 95% CIS were calculated using polytomous logistic regression.Results HN melanoma patients were substantially more likely than trunk patients to have higher levels of sun exposure in adulthood (OR, 2.43; 95% CI, 0.98 to 5.99) and specifically, higher levels of occupational exposure (OR, 3.25; 95% CI, 1.32 to 8.00), but lower levels of recreational sun exposure (OR, 0.50; 95% CI, 0.21 to 1.19). LM and LMM patients reported higher occupational exposure and lower recreational sun exposure than trunk melanoma patients, although this was not significant. We found no significant differences between the groups for school-age sun exposures.Conclusion Melanomas developing at different body sites are associated with distinct patterns of sun exposure. Melanomas of the head and neck are associated with chronic patterns of sun exposure whereas trunk melanomas are associated with intermittent patterns of sun exposure, supporting the hypothesis that melanomas may arise through divergent causal pathways.