Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden, Germany
Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden, Germany
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DOI：
10.1111/jdv.12488
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发表时间：
2015-01-01
影响因子：
9.2
通讯作者：
Kron, M.
中科院分区：
文献类型：
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作者：
Kaskel, P.;Lange, U.;Kron, M.
背景欧洲黑色素瘤和基底细胞癌（BCC）的发病率持续增加。很少有研究评估这两种肿瘤的各种危险因素。目的这项预先计划的额外分析直接比较了职业和过去的紫外线暴露行为，并检查了黑色素瘤和散发性基底细胞癌之间阳光敏感性的影响，并评估了其对这两个实体的重要性。患者/方法该研究包括 503 名患者（黑色素瘤，n = 291 和基底细胞癌，n = 212），以及来自德国的 329 名对照。总共有 244 名病例 (49%) 和 165 名对照者 (50%) 为男性（黑色素瘤中位年龄为 55 岁；BCC，69 岁；对照者为 57 岁）。通过多级逻辑回归中的向后消除来选择重要的危险因素。结果当直接比较黑色素瘤和散发性基底细胞癌时，光化性弹性组织变性（OR 48.83; 95% CI 17.87, 133.40）和部位与黑色素瘤的较高风险相关，而儿童时期登山、诊断前20年晒伤、全职耕种、一般日光浴床使用、脂溢性角化病、光化性唇炎、光化性角化病和年龄与散发性基底细胞癌的较高风险相关。黑色素瘤发生前 20 年从事园艺、头发颜色和日光性雀斑是这两种疾病的危险因素。对排除雀斑样黑色素瘤实体（即肢端雀斑样痣和恶性雀斑样痣黑色素瘤）的数据进行重新评估，结果选择了相同的因素。然而，与对照相比，特应性分别演变为黑色素瘤（OR 0.29；95% CI 0.15，0.57）和基底细胞癌（OR 0.41；95% CI 0.17，0.99）的保护因素，但与黑色素瘤相比，与散发性基底细胞癌的风险更高有关。结论与基底细胞癌相比，基底细胞癌发生临床光化性弹性组织变性的几率较低。黑色素瘤。相比之下，与慢性紫外线暴露和年龄相关的各种因素导致散发性基底细胞癌的几率高于黑色素瘤。需要进一步的研究来确定这些发现的背景，特别是关于非雀斑型与雀斑型黑色素瘤的特应性，以及可能涉及的分子途径。
BackgroundThere is a perpetuating increase in melanoma and basal cell carcinoma (BCC) incidence in Europe. Few studies are evaluating various risk factors for both tumours.ObjectivesThis pre-planned additional analysis directly compared occupational and past-time ultraviolet exposure behaviour, and examined the effects of sun sensitivity between melanoma and sporadic BCC, and assessed its importance for the two entities.Patients/MethodsThe study included 503 patients (melanoma, n=291 and BCC, n=212), and 329 controls from Germany. In all, 244 (49%) of the cases and 165 (50%) of the controls were male (median age melanoma, 55years; BCC, 69years; and controls, 57years). Selection of important risk factors was performed by backward elimination in a polytomous logistic regression.ResultsWhen directly comparing melanoma and sporadic BCC, actinic elastosis (OR 48.83; 95% CI 17.87, 133.40) and site were associated with a higher risk of melanoma, whereas mountaineering in childhood, sunburn 20years before diagnosis, farming full time, sunbed use in general, seborrheic keratosis, actinic cheilitis, actinic keratosis and age were associated with a higher risk of sporadic BCC. Gardening 20years before melanoma, hair colour and solar lentigo were risk factors for both entities. A re-evaluation of the data excluding lentiginous melanoma entities (i.e. acro-lentiginous and lentigo-maligna melanoma) resulted in selection of the same factors. However, compared to controls, atopy evolved as a protective factor for melanoma (OR 0.29; 95% CI 0.15, 0.57) and BCC (OR 0.41; 95% CI 0.17, 0.99), respectively, but was associated with a higher risk of sporadic BCC compared to melanoma.ConclusionThe odds for having clinical actinic elastosis was lower in BCC compared to melanoma. In contrast, various factors associated with chronic UV exposure and age had higher odds for sporadic BCC, rather than melanoma. Further research is required to set the context for these findings, especially regarding, atopy in non-lentiginous vs. lentiginous forms of melanoma, and possible molecular pathways involved.