Gandini Sara, Montella Maurizio, Ayala Fabrizio, Benedetto Lucia, Rossi Carlo Riccardo, Vecchiato Antonella, Corradin Maria Teresa, DE Giorgi Vincenzo, Queirolo Paola, Zannetti Guido, Giudice Giuseppe, Borroni Giovanni, Forcignanò Rosachiara, Peris Ketty, Tosti Giulio, Testori Alessandro, Trevisan Giusto, Spagnolo Francesco, Ascierto Paolo A
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan I-20146, Italy.
Department of Epidemiology, National Cancer Institute 'G. Pascale' Foundation, Naples I-80131, Italy.
Oncol Lett. 2016 Apr;11(4):2706-2714. doi: 10.3892/ol.2016.4292. Epub 2016 Mar 1.
Previous studies have reported an association between sun exposure and the increased survival of patients with cutaneous melanoma (CM). The present study analyzed the association between ultraviolet (UV) light exposure and various prognostic factors in the Italian Clinical National Melanoma Registry. Clinical and sociodemographic features were collected, as well as information concerning sunbed exposure and holidays with sun exposure. Analyses were performed to investigate the association between exposure to UV and melanoma prognostic factors. Between December 2010 and December 2013, information was obtained on 2,738 melanoma patients from 38 geographically representative Italian sites. A total of 49% of the patients were >55 years old, 51% were men, 50% lived in the north of Italy and 57% possessed a high level of education (at least high school). A total of 8 patients had a family history of melanoma and 56% had a fair phenotype (Fitzpatrick skin type I or II). Of the total patients, 29% had been diagnosed with melanoma by a dermatologist; 29% of patients presented with a very thick melanoma (Breslow thickness, >2 mm) and 25% with an ulcerated melanoma. In total, 1% of patients had distant metastases and 13% exhibited lymph node involvement. Holidays with sun exposure 5 years prior to CM diagnosis were significantly associated with positive prognostic factors, including lower Breslow thickness (P<0.001) and absence of ulceration (P=0.009), following multiple adjustments for factors such as sociodemographic status, speciality of doctor performing the diagnosis and season of diagnosis. Sunbed exposure and sun exposure during peak hours of sunlight were not significantly associated with Breslow thickness and ulceration. Holidays with sun exposure were associated with favorable CM prognostic factors, whereas no association was identified between sunbed use and sun exposure during peak hours of sunlight with favorable CM prognostic factors. However, the results of the present study do not prove a direct causal effect of sun exposure on melanoma prognosis, as additional confounding factors, including vitamin D serum levels, may have a role.
以往研究报道了阳光照射与皮肤黑色素瘤（CM）患者生存率提高之间的关联。本研究在意大利国家黑色素瘤临床登记处分析了紫外线（UV）照射与各种预后因素之间的关联。收集了临床和社会人口学特征，以及有关日光浴床照射和阳光照射假期的信息。进行分析以研究紫外线照射与黑色素瘤预后因素之间的关联。在2010年12月至2013年12月期间，从意大利38个具有地理代表性的地点获取了2738例黑色素瘤患者的信息。共有49%的患者年龄>55岁，51%为男性，50%居住在意大利北部，57%具有高学历（至少高中）。共有8例患者有黑色素瘤家族史，56%具有白皙的表型（菲茨帕特里克皮肤类型I或II）。在所有患者中，29%由皮肤科医生诊断为黑色素瘤；29%的患者表现为非常厚的黑色素瘤（ Breslow厚度，>2mm），25%为溃疡型黑色素瘤。总共有1%的患者有远处转移，13%有淋巴结受累。在对社会人口学状况、进行诊断的医生专业和诊断季节等因素进行多次调整后，CM诊断前5年的阳光照射假期与阳性预后因素显著相关，包括较低的Breslow厚度（P<0.001）和无溃疡（P=0.009）。日光浴床照射和阳光照射高峰时段的阳光照射与Breslow厚度和溃疡无显著关联。阳光照射假期与CM的有利预后因素相关，而日光浴床使用和阳光照射高峰时段的阳光照射与CM的有利预后因素之间未发现关联。然而，本研究结果并未证明阳光照射对黑色素瘤预后有直接因果效应，因为包括血清维生素D水平在内的其他混杂因素可能起作用。
