Collier Victoria, Patel Jay, Chiu Chi-Yang, Fowke Jay H, Patel Tejesh Surendr, Liu-Smith Feng
Department of Dermatology.
College of Medicine.
Clin Exp Dermatol. 2023 Nov 16;48(12):1333-1340. doi: 10.1093/ced/llad236.
Cutaneous melanomas (CMs) are more frequently found on the trunk in men, and on the hip and lower extremities (legs) in women. This discrepancy has been attributed to greater exposure to ultraviolet (UV) radiation of women's legs due to their dressing habits.
To understand the sex difference in the bodily distribution of CMs, especially those on the legs.
This was a cancer registry-based cohort study. CM incidences, relative tumour density and tumour mutational burdens (TMBs) were compared among different body sites in different sex and racial groups using the SEER (Surveillance, Epidemiology, and End Results) and TCGA SKCM (The Cancer Genome Atlas skin cutaneous melanoma) databases.
White men had lower rates and lower relative tumour density (RTD) of CMs on their legs compared with the rest of their body sites, or compared with White women. Men classified by SEER into racial groups other than White did not show such a trend. White women had comparable RTDs among different body sites. The ratios between the 'White' and the 'other' groups were used to evaluate the approximate effect of sun exposure at different body sites, which further validated a distinct protective effect of men's legs in melanoma. TMB on leg melanomas was lower than on other sites in both sexes.
The legs of both sexes in White patients show lower RTDs and lower levels of TMB, suggesting a weaker association with UV exposure. Furthermore, White men are especially protected against CM on their legs, suggesting an unknown intrinsic protective factor as compared with women.
皮肤黑色素瘤（CMs）在男性中更常见于躯干，而在女性中更常见于臀部和下肢（腿部）。这种差异归因于女性的着装习惯使其腿部受到更多紫外线（UV）辐射。
了解CMs在身体分布上的性别差异，尤其是腿部的差异。
这是一项基于癌症登记处的队列研究。使用监测、流行病学和最终结果（SEER）以及癌症基因组图谱皮肤黑色素瘤（TCGA SKCM）数据库，比较不同性别和种族群体不同身体部位的CM发病率、相对肿瘤密度和肿瘤突变负担（TMB）。
与身体其他部位相比，或与白人女性相比，白人男性腿部的CM发病率和相对肿瘤密度（RTD）较低。SEER分类为非白人种族群体的男性未显示出这种趋势。白人女性不同身体部位的RTD相当。用“白人”和“其他”群体之间的比率来评估不同身体部位阳光照射的大致影响，这进一步证实了男性腿部在黑色素瘤方面具有明显的保护作用。两性腿部黑色素瘤的TMB均低于其他部位。
白人患者两性的腿部均显示出较低的RTD和较低水平的TMB，表明与紫外线暴露的关联较弱。此外，白人男性在腿部尤其受到CM的保护作用，这表明与女性相比存在未知的内在保护因素。
