Mitkov Mario, Joseph Richard, Copland John
Mayo Clinic Department of Dermatology, Jacksonville, FL, USA; Creighton University School of Medicine, Omaha, NE, USA.
Mayo Clinic Department of Oncology, Jacksonville, FL, USA.
Mol Cell Endocrinol. 2015 Dec 5;417:94-102. doi: 10.1016/j.mce.2015.09.020. Epub 2015 Sep 28.
Disparities in the prognosis and incidence of melanoma between male and female patients have led clinicians to explore the influence of steroid hormones on the development and progression of this malignancy. A better understanding of the disparities of melanoma behavior between sexes and ages could lead to improved prevention and treatment options. There are multiple themes in the literature that unify the physiologic functions of estrogen and androgen receptors; herein we discuss and map their pathways. Overall, it is important to understand that the differences in melanoma behavior between the sexes are multifactorial and likely involve interactions between the immune system, endocrine system, and environment, namely UV-radiation. Melanoma deserves a spot among hormone-sensitive tumors, and if tamoxifen is re-introduced for future therapy, tissue ratios of estrogen receptors should be obtained beforehand to assess their therapeutic predictive value. Because androgens, estrogens, and their receptors are involved in signaling of commonly mutated melanoma pathways, potential synergistic properties of the recently developed molecular kinase inhibitors that target those pathways may exist.
男性和女性黑色素瘤患者在预后和发病率上的差异促使临床医生探究类固醇激素对这种恶性肿瘤发生和发展的影响。更好地理解黑色素瘤在性别和年龄上行为的差异可能会带来更好的预防和治疗方案。文献中有多个主题将雌激素和雄激素受体的生理功能统一起来;在此我们讨论并梳理它们的信号通路。总体而言,重要的是要明白,黑色素瘤在性别间行为的差异是多因素的,可能涉及免疫系统、内分泌系统和环境(即紫外线辐射)之间的相互作用。黑色素瘤应在激素敏感肿瘤中占有一席之地,如果未来重新引入他莫昔芬进行治疗,应事先获取雌激素受体的组织比率以评估其治疗预测价值。由于雄激素、雌激素及其受体参与了黑色素瘤常见突变信号通路的传导,针对这些通路的最新开发的分子激酶抑制剂可能存在潜在的协同特性。