De Giorgi Vincenzo, Gori Alessia, Savarese Imma, D'Errico Antonietta, Scarfì Federica, Papi Federica, Maio Vincenza, Covarelli Piero, Massi Daniela, Gandini Sara
Department of Dermatology, University of Florence, Via Michelangelo 41, 50124, Florence, Italy.
Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy.
J Cancer Res Clin Oncol. 2017 Jul;143(7):1191-1197. doi: 10.1007/s00432-017-2387-5. Epub 2017 Mar 13.
Currently, the association between body mass index (BMI) and hormone therapies and Cutaneous Melanoma (CM) development is strongly debated. This study was carried out to assess the association between BMI, hormone therapies, and CM risk.
The present study is a hospital-based case-control study with 605 consecutive CM patients and 592 controls treated for non-neoplastic conditions at the Department of Dermatology in Florence. The associations of melanoma risk with BMI and hormone therapies were assessed performing unconditional logistic regression to estimate odds ratios (OR) and their 95% confidence intervals, adjusting for potential confounders.
We found a significant interaction of BMI with age (P < 0.0001): being overweight significantly increased CM risk among individuals less than 50 years old (OR = 1.85 with 95% CI 1.14-2.94), whereas the association was not significant for individuals over 50 years old (OR = 1.15 with 95% CI 0.77-1.71). For oestrogen therapy, women taking oral contraceptives (OCs)/hormone replacement therapy (HRT) showed a lower CM risk than men (OR = 0.63, 95% CI 0.44-0.89), with risk estimates significantly lower (P < 0.0001) than in non OCs/HRT users, which had an increased risk compared to men (OR = 1.81, 95% CI 1.29-2.53).
Being overweight was significantly associated with CM risk, and this relationship was highly age-conditioned; the second finding was the protective effect of oestrogen therapies for women. Both findings may have a significant impact on melanoma prevention, as the prevalence of obesity and hormone therapy use is increasing worldwide.
目前，体重指数（BMI）与激素疗法和皮肤黑色素瘤（CM）发生之间的关联存在激烈争论。本研究旨在评估BMI、激素疗法与CM风险之间的关联。
本研究是一项基于医院的病例对照研究，纳入了佛罗伦萨皮肤科连续收治的605例CM患者和592例因非肿瘤性疾病接受治疗的对照。通过无条件逻辑回归评估黑色素瘤风险与BMI和激素疗法的关联，以估计比值比（OR）及其95%置信区间，并对潜在混杂因素进行调整。
我们发现BMI与年龄存在显著交互作用（P < 0.0001）：超重显著增加了50岁以下个体的CM风险（OR = 1.85，95% CI 1.14 - 2.94），而50岁以上个体的这种关联不显著（OR = 1.15，95% CI 0.77 - 1.71）。对于雌激素疗法，服用口服避孕药（OCs）/激素替代疗法（HRT）的女性CM风险低于男性（OR = 0.63，95% CI 0.44 - 0.89），风险估计值显著低于未使用OCs/HRT的人群（P < 0.0001），后者与男性相比风险增加（OR = 1.81，95% CI 1.29 - 2.53）。
超重与CM风险显著相关，且这种关系受年龄影响很大；第二个发现是雌激素疗法对女性具有保护作用。这两个发现可能对黑色素瘤的预防产生重大影响，因为全球肥胖和激素疗法的使用患病率正在上升。
