Chalada Melissa, Ramlogan-Steel Charmaine A, Dhungel Bijay P, Layton Christopher J, Steel Jason C
School of Health, Medical and Applied Sciences, Central Queensland University, Norman Gardens, QLD 4701, Australia.
Gene and Stem Cell Therapy Program Centenary Institute, University of Sydney, Camperdown, NSW 2006, Australia.
Cancers (Basel). 2021 Apr 3;13(7):1700. doi: 10.3390/cancers13071700.
Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.
葡萄膜黑色素瘤(UM)目前被世界卫生组织归类为由累积日光损伤以外的风险因素引起的黑色素瘤。然而,与紫外线辐射(UVR)易感性相关的因素,如浅色皮肤和眼睛、易晒伤倾向以及靠近赤道,常常与更高的UM风险相关。这些风险因素与更为常见的皮肤黑色素瘤(CM)的风险因素相似,而皮肤黑色素瘤被广泛认为是由过度暴露于UVR引起的,这表明UVR在一部分UM的发生和发展中起作用。事实上,这可能意味着,如果UVR暴露真的起作用,那么像澳大利亚这样UVR暴露水平高且CM发病率最高的国家,UM发病率也会同样高。大多数UM病例缺乏与UVR损伤相关的典型基因突变,尽管最近在少数病例中的证据显示并非如此。因此,本综述重新评估了支持和反对UVR在UM病因学中作用的统计、环境、解剖学和生理学证据。