University of Manchester and Manchester Royal Eye Hospital, Manchester, UK.
Br J Ophthalmol. 2012 Nov;96(11):1415-9. doi: 10.1136/bjophthalmol-2012-301812. Epub 2012 Sep 13.
Uveal melanoma is the commonest primary intraocular malignancy in adults, and leads to death in approximately half of patients. The aim was to report on trends over time and geographical variation in rates of uveal melanoma in England.
Analysis of admissions for uveal melanoma, using linked English national hospital episode statistics, available from 1999 to 2010, and the Oxford record linkage study (ORLS), before that, from 1979 to 1998.
The annual rate of people admitted in England with a new record of uveal melanoma remained stable at approximately 1.0 people per 100 000 population from 1999 to 2010. Annual ORLS incidence rates were also stable from 1979 to 1998. Proportions of new uveal malignancies in adults for 2006-10 were 88% (382 people/year) choroidal and 12% (52) ciliary body/iris. Incidence rates increased with increasing age and were higher in men than women. Geographical analysis showed variation across local authorities (LA) in incidence rates, from 0.1 to 1.9 people per 100 000 population per year. Incidence rates at the LA level were inversely correlated with the proportion of black (r=-0.18) or Indian individuals (r=-0.13) in each LA, were weakly correlated with LA levels of social deprivation (r=0.08) and were not correlated with southerly latitude.
The annual incidence of uveal melanoma in England has remained stable over the past decade. This contrasts with the rising incidence of cutaneous melanoma. Our data do not support the possibility that ultraviolet light exposure contributes to the pathogenesis of uveal melanoma.
葡萄膜黑色素瘤是成年人中最常见的原发性眼内恶性肿瘤,约有一半的患者因此死亡。本研究旨在报告英国葡萄膜黑色素瘤发病率随时间的变化趋势和地域差异。
利用 1999 年至 2010 年全国医院病例统计数据(EHES)和牛津地区记录链接研究(ORLS),对葡萄膜黑色素瘤患者进行分析。在此之前,还对 1979 年至 1998 年的数据进行了分析。
1999 年至 2010 年,英国每年因新记录的葡萄膜黑色素瘤而入院的人数稳定在每 10 万人中有 1.0 人左右。1979 年至 1998 年,ORLS 年度发病率也保持稳定。2006 年至 2010 年,成年人新确诊的葡萄膜恶性肿瘤中,脉络膜占 88%(382 人/年),睫状体/虹膜占 12%(52 人)。发病率随年龄增长而增加,男性高于女性。地域分析显示,各地方当局(LA)的发病率存在差异,从每年每 10 万人中有 0.1 人至 1.9 人不等。LA 级别的发病率与每个 LA 中黑人和/或印度人的比例呈负相关(r=-0.18 和 r=-0.13),与 LA 级别的社会贫困程度呈弱相关(r=0.08),与纬度无相关性。
在过去的十年中,英国葡萄膜黑色素瘤的年发病率保持稳定。这与皮肤黑色素瘤发病率的上升形成对比。我们的数据不支持紫外线照射导致葡萄膜黑色素瘤发病的可能性。