F-de-Misa Ricardo, Hernández-Jimenez José Gerardo, Carretero Hernández Gregorio, Pérez-Méndez Lina, Aguirre-Jaime Armando, Flores Carlos, Suárez Hernández José, Perera Molinero Antonio, Claveríe-Martín Félix
Dermatology Department, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
J Dermatol Sci. 2008 Dec;52(3):186-92. doi: 10.1016/j.jdermsci.2008.06.001. Epub 2008 Jul 25.
Alpha-melanocyte-stimulating hormone receptor 1 (MC1R) has an important role in skin pigmentation and variants of the gene have been established as independent risk factors for susceptibility to cutaneous malignant melanoma.
To explore whether variants of the gene also influence the onset of the disease.
We analyzed 285 melanoma patients of European ancestry for common variation in codon 84 (D84E) of the alpha-MSH receptor 1 gene, which is known to have functional consequences in MC1R protein activity.
The mean age difference at diagnosis between MC1R 84E carriers and non-carriers was 9 years (95% confidence interval [CI]: 2-17; p=0.012), with 84E non-carrier patients being older. After adjusting for gender, Clark's level, phototype, eyes and hair colour, the risk for cutaneous malignant melanoma at any age was 2.07 times higher (95% CI: 1.21-3.52; p=0.008) among MC1R 84E carriers. Enrolment criteria, geographical origin, Clark's levels and Breslow's indexes were similar between MC1R 84E carriers and non-carriers. Further analyses based on the Clark level and Breslow's index, both indicative for cancer invasion, reasonably supported an unbiased selection of patients during the study enrolment. Additional exon re-sequencing of the cyclin-dependent kinase inhibitor 2A (CDKN2A) gene in MC1R 84E carriers ruled out the presence of high penetrance mutations that have previously been associated with early onset of the disease.
Although our findings need to be confirmed by independent and larger studies we have described for the first time the association of D84E variant of the alpha-MSH receptor 1 gene as an independent risk factor for an earlier onset of cutaneous malignant melanoma.
α-黑素细胞刺激素受体1(MC1R)在皮肤色素沉着中起重要作用,该基因的变异已被确定为皮肤恶性黑色素瘤易感性的独立危险因素。
探讨该基因变异是否也影响疾病的发病。
我们分析了285名欧洲血统的黑色素瘤患者α-MSH受体1基因密码子84(D84E)的常见变异,已知该变异对MC1R蛋白活性有功能性影响。
MC1R 84E携带者与非携带者诊断时的平均年龄差异为9岁(95%置信区间[CI]:2-17;p=0.012),84E非携带者患者年龄更大。在调整性别、克拉克分级、光类型、眼睛和头发颜色后,MC1R 84E携带者在任何年龄患皮肤恶性黑色素瘤的风险高2.07倍(95%CI:1.21-3.52;p=0.008)。MC1R 84E携带者与非携带者的入选标准、地理来源、克拉克分级和 Breslow指数相似。基于克拉克分级和 Breslow指数(均指示癌症侵袭)的进一步分析合理支持了研究入选期间患者的无偏选择。对MC1R 84E携带者的细胞周期蛋白依赖性激酶抑制剂2A(CDKN2A)基因进行额外的外显子重测序排除了先前与疾病早发相关的高穿透性突变的存在。
尽管我们的发现需要通过独立的更大规模研究来证实,但我们首次描述了α-MSH受体1基因D84E变异作为皮肤恶性黑色素瘤早发的独立危险因素的关联。