Siskind Victor, Whiteman David C, Aitken Joanne F, Martin Nicholas G, Green Adèle C
Division of Population Studies and Human Genetics, Queensland Institute of Medical Research, Brisbane, QLD, Australia.
Cancer Causes Control. 2005 Apr;16(3):193-9. doi: 10.1007/s10552-004-4325-5.
Emerging evidence suggests that melanomas arising on the head and neck that are not lentigo maligna melanomas have different associations with phenotypic and environmental risk factors than those on the trunk and other sites. We sought to test this hypothesis in a population-based study in Queensland, Australia.
Risk factor data were collected from 2360 participants with incident cutaneous melanoma diagnosed 1982--1990, including 167 participants with lentigo maligna melanoma. For each risk factor, polytomous logistic regression analysis, using the trunk as a reference category, was used to estimate the odds ratio and 95% confidence interval for cutaneous melanomas by anatomical site.
Participants with melanomas of the head and neck were significantly older than those with melanomas of the trunk (males 52.7 versus 49.7 years; females 47.8 versus 40.5 years). Compared with patients with truncal melanomas, those of the head and neck were less likely to have many nevi (OR 0.41, 95% CI 0.13--1.31), although this did not reach statistical significance. Among females, melanomas of the lower limb were negatively associated with a past history of non-melanoma skin cancer (OR 0.41, 95% CI 0.23-0.74).
We have observed heterogeneity for melanoma risk by anatomical site, lending weight to the hypothesis that cutaneous melanomas may develop through multiple causal pathways.
新出现的证据表明，头颈部发生的非恶性雀斑样痣黑色素瘤与躯干及其他部位的黑色素瘤相比，在表型和环境风险因素方面存在不同的关联。我们试图在澳大利亚昆士兰州的一项基于人群的研究中验证这一假设。
收集了1982年至1990年确诊的2360例新发皮肤黑色素瘤患者的风险因素数据，其中包括167例恶性雀斑样痣黑色素瘤患者。对于每个风险因素，以躯干为参照类别，采用多分类逻辑回归分析来估计不同解剖部位皮肤黑色素瘤的比值比及95%置信区间。
头颈部黑色素瘤患者的年龄显著大于躯干黑色素瘤患者（男性为52.7岁对49.7岁；女性为47.8岁对40.5岁）。与躯干黑色素瘤患者相比，头颈部黑色素瘤患者有多个痣的可能性较小（比值比0.41，95%置信区间0.13 - 1.31），尽管这未达到统计学显著性。在女性中，下肢黑色素瘤与既往非黑色素瘤皮肤癌病史呈负相关（比值比0.41，95%置信区间0.23 - 0.74）。
我们观察到黑色素瘤风险在解剖部位上存在异质性，这支持了皮肤黑色素瘤可能通过多种因果途径发展的假设。
