Seddon J M, Gragoudas E S, Glynn R J, Egan K M, Albert D M, Blitzer P H
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114.
Arch Ophthalmol. 1990 Sep;108(9):1274-80. doi: 10.1001/archopht.1990.01070110090031.
Uveal melanoma threatens life, as well as sight. To evaluate the effect of constitutional factors and UV radiation on the risk of uveal melanoma, 197 cases in New England were compared with 385 matched population controls, identified by random-digit dialing, and 337 cases residing within the United States were compared with 800 sibling controls. In the population-based comparison, estimated relative risks (RRs) of uveal melanoma, after adjustment for other factors, were elevated for the following: ancestry from more northern latitudes with a substantially elevated risk for Northern European ancestry (RR, 6.5; 95% confidence interval [CI], 1.9 to 22.4) and more than a twofold risk for British ancestry (RR, 2.4; 95% CI, 1.1 to 5.1), as compared with Southern European or other Mediterranean heritage; light skin color as compared with dark (RR, 3.8; 95% CI, 1.1 to 12.6); and 10 or more cutaneous nevi as compared with none (RR, 2.7; 95% CI, 1.5 to 4.9). There was a statistically significant trend for increasing risk with more northern heritage and more moles. Southern residence (below latitude 40 degrees N) for more than 5 years also increased risk (RR, 2.8; 95% CI, 1.1 to 6.9), as compared with none. In both comparisons, use of sunlamps was a risk determinant (RR, 3.4; 95% CI, 1.1 to 10.3 with random-digit dialed controls and RR, 2.3; 95% CI, 1.2 to 4.3 with sibling controls, comparing occasional or frequent use to never use), as was intense sun exposure (RR, 1.7; 95% CI, 0.9 to 3.0 and RR, 2.1; 95% CI, 1.4 to 3.2, respectively). However, birthplace below latitude 40 degrees N and outdoor work were associated with a lower risk.(ABSTRACT TRUNCATED AT 250 WORDS)
葡萄膜黑色素瘤不仅威胁视力,还危及生命。为评估体质因素和紫外线辐射对葡萄膜黑色素瘤风险的影响,将新英格兰地区的197例患者与通过随机数字拨号确定的385名匹配的人群对照进行比较,并将美国境内的337例患者与800名同胞对照进行比较。在基于人群的比较中,在对其他因素进行调整后,葡萄膜黑色素瘤的估计相对风险(RRs)在以下情况升高:来自纬度更高地区的血统,北欧血统的风险大幅升高(RR,6.5;95%置信区间[CI],1.9至22.4),英国血统的风险则高出两倍多(RR,2.4;95%CI,1.1至5.1),与南欧或其他地中海血统相比;浅肤色与深肤色相比(RR,3.8;95%CI,1.1至12.6);有10个或更多皮肤痣与无皮肤痣相比(RR,2.7;95%CI,1.5至4.9)。随着血统来自更靠北地区和痣数量增多,风险增加存在统计学显著趋势。与从未居住在南方(北纬40度以下)相比,在南方居住超过5年也会增加风险(RR,2.8;95%CI,1.1至6.9)。在两项比较中,使用太阳灯都是一个风险决定因素(与随机数字拨号对照相比,RR,3.4;95%CI,1.1至10.3,与同胞对照相比,RR,2.3;95%CI,1.2至4.3,将偶尔或频繁使用与从不使用进行比较),强烈阳光照射也是如此(分别为RR,1.7;95%CI,0.9至3.0和RR,2.1;95%CI,1.4至3.2)。然而,出生在北纬40度以下地区和从事户外工作与较低风险相关。(摘要截取自250字)