Department of Oncology and Pathology, Karolinska Institutet and Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden.
Acta Oncol. 2011 Apr;50(3):323-8. doi: 10.3109/0284186X.2010.535846. Epub 2011 Feb 8.
UV radiation is a major factor in melanoma genesis, but non-UV linked factors are also operational, since primary malignant melanomas can emerge in body sites that never see the sun. The scarcity of melanomas in sun-shielded body sites reflects only the absolute number of melanomas, not the number of tumours per square unit of the surface in which they emerge. Studies on melanoma density conducted by us and others are here briefly reviewed. The access to reliable numbers along with measurable anatomical areas directed our choice of melanomas at the sun-shielded locations described here. Melanomas at the body surface. Calculations of surface areas bearing melanomas relative to the total body surface included sites on the vulva, subungual tissues, volar and palmar skin, and, for comparison melanomas of the face during the same period of time. The density of vulvar melanomas was identical to that in chronically sun-exposed facial skin. Subungual melanomas were almost nine times denser than expected whereas melanomas of palms and soles showed a lower density than expected. Melanomas beneath the body surface. The densities of melanomas in the vagina, anal canal and uvea, were calculated separately and compared to the average density of cutaneous melanomas (CMMs) during the same period of time. Melanomas of the anal canal displayed a density almost twice the average for CMMs, whereas the vaginal melanomas were similar in density to CMMs. In contrast, the density of the uveal melanomas was calculated as 50 and 41 times (men and women, respectively) the average density of CMMs.
The high density of some melanomas in sun-shielded body areas indicates the presence of factors underlying the origins of these tumours that seem to be equivalent in strength to UV radiation and also implies that specific anatomical sites favour the emergence and proliferation of melanomas, independent of UV radiation.
紫外线辐射是黑色素瘤发生的一个主要因素，但非紫外线相关因素也在起作用，因为原发性恶性黑色素瘤可以出现在从未接触过阳光的身体部位。在避光部位黑色素瘤的稀少反映的只是黑色素瘤的绝对数量，而不是它们出现的表面每平方单位的肿瘤数量。我们和其他人进行的关于黑色素瘤密度的研究在这里被简要回顾。为了获得可靠的数字和可测量的解剖区域，我们选择了这里描述的避光部位的黑色素瘤。身体表面的黑色素瘤。相对于整个身体表面计算有黑色素瘤的表面积，包括外阴、甲下组织、手掌和足底皮肤，以及同期的面部黑色素瘤。外阴黑色素瘤的密度与慢性暴露于阳光的面部皮肤相同。甲下黑色素瘤的密度几乎是预期的九倍，而手掌和足底的黑色素瘤密度则低于预期。身体表面以下的黑色素瘤。阴道、肛门和葡萄膜黑色素瘤的密度分别计算，并与同期皮肤黑色素瘤（CMMs）的平均密度进行比较。肛门黑色素瘤的密度几乎是 CMMs 平均密度的两倍，而阴道黑色素瘤的密度与 CMMs 相似。相比之下，葡萄膜黑色素瘤的密度被计算为 CMMs 平均密度的 50 倍和 41 倍（男性和女性分别）。
一些避光部位黑色素瘤的高密度表明，这些肿瘤的起源存在一些因素，这些因素的强度似乎与紫外线辐射相当，这也意味着特定的解剖部位有利于黑色素瘤的出现和增殖，而与紫外线辐射无关。
