Nosrati Adi, Wei Maria L
Dermatology Service, Veterans Affairs Medical Center, San Francisco, CA, United States; Department of Dermatology, University of California, San Francisco, United States.
Dermatology Service, Veterans Affairs Medical Center, San Francisco, CA, United States; Department of Dermatology, University of California, San Francisco, United States.
Arch Biochem Biophys. 2014 Dec 1;563:42-50. doi: 10.1016/j.abb.2014.06.018. Epub 2014 Jul 21.
Melanoma outcomes differ between men and women even when adjusted for prognostic factors such as age, Breslow thickness, body site, ulceration, lymph node dissection, and for treatment, with men having poorer outcomes compared to women. The mechanisms underlying this disparity are not well understood. Behavioral differences between the sexes such as ultraviolet light exposure and health care services utilization have been suggested as contributing, and differences in endogenous biological processes such as immune function, hormonal regulation, oxidative stress response, vitamin D metabolism and sex chromosome gene expression have also been proposed as mechanisms. This review examines the cumulative evidence for biologically based processes that lead to differences in melanoma biology, including inherent sex-based differences in immune function, oxidative stress response and vitamin D metabolism; the complex interplay between sex hormones, the immune system and oxidative stress response; the effect of non-random X chromosome inactivation on tumorigenesis; and the potential contribution of recently identified oncogenes on the Y chromosome.
即使在对年龄、 Breslow厚度、身体部位、溃疡、淋巴结清扫等预后因素以及治疗进行调整后，黑色素瘤的预后在男性和女性之间仍存在差异，男性的预后比女性差。这种差异背后的机制尚未完全了解。有人认为，两性之间的行为差异，如紫外线暴露和医疗服务利用情况，是造成这种差异的原因之一；也有人提出，内源性生物过程的差异，如免疫功能、激素调节、氧化应激反应、维生素D代谢和性染色体基因表达，也是造成这种差异的机制。本综述考察了导致黑色素瘤生物学差异的基于生物学过程的累积证据，包括免疫功能、氧化应激反应和维生素D代谢中固有的性别差异；性激素、免疫系统和氧化应激反应之间的复杂相互作用；非随机X染色体失活对肿瘤发生的影响；以及最近在Y染色体上发现的致癌基因的潜在作用。
