Navarro-Bielsa Alba, Gracia-Cazaña Tamara, Almagro Manuel, De la Fuente-Meira Sonia, Flórez Ángeles, Yélamos Oriol, Montero-Vilchez Trinidad, González-Cruz Carlos, Diago Adrián, Abadías-Granado Isabel, Fuentelsaz Victoria, Colmenero María, Bañuls José, Arias-Santiago Salvador, Buendía-Eisman Agustín, Almenara-Blasco Manuel, Gil-Pallares Pedro, Gilaberte Yolanda
Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, Universidad de Zaragoza, 50009 Zaragoza, Spain.
Department of Dermatology, Complejo Hospitalario Universitario A Coruña, 15006 A Coruña, Spain.
Cancers (Basel). 2023 Nov 12;15(22):5376. doi: 10.3390/cancers15225376.
The concept of exposome refers to the total of harmful and beneficial environmental exposures that can help predict the organism's biological responses over time. Ultraviolet radiation (UVR) from sun exposure has been recognized as the main etiological agent of skin cancer, and squamous cell carcinoma (SCC) is one most commonly associated with chronic exposure. However, in recent years, evidence suggests that lifestyle, environmental pollution, and contaminants in water and food can have an influence.
To study the relationship between SCC and sun exposure, pollution, stress, and lifestyle in a Spanish cohort.
A multicenter case-control study was carried out in which 13 dermatologists from different regions of Spain recruited cases and controls between April 2020 and August 2022. The group of cases were patients diagnosed with SCC and, as a control group, people who attended Dermatology consultations as companions with no history of skin cancer.
A total of 62 patients with SCC and 126 controls were included (62.9% males, median age 76.46 (10.1) and 33.3%, median age 55.7 (15), respectively). The SCC group had experienced more outside work than the controls (75% vs. 22.4%, < 0.001), less recreational exposure (sunbathing, = 0.05, and outdoor sports, = 0.01), and a lower annual income ( = 0.01), with an increase in tobacco exposure ( < 0.001), without differences in other carcinogens, such as ionizing radiation or chemical exposure. The control group had a higher daily screentime use ( < 0.001) and practiced more relaxation activities ( = 0.03). A higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with SCC ( < 0.05). Some chronic medications (anxiolytics, antidepressants, beta-blockers, statins, hydrochlorothiazide, ACE inhibitors, metformin, and omeprazole) were also statistically associated with SCC. Statistical significance for all aforementioned variables was maintained in the multivariate analysis ( < 0.05).
The study found a significant association between SCC and multiple exposome-related factors in addition to chronic sun exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers promoting sun-safe behaviors and stress-reducing activities, in addition to adequate skin photoprotection in patients under certain medications associated with SCC.
暴露组的概念是指有害和有益环境暴露的总和，这些暴露有助于预测生物体随时间的生物学反应。阳光中的紫外线辐射（UVR）已被确认为皮肤癌的主要病因，鳞状细胞癌（SCC）是最常与慢性暴露相关的一种。然而，近年来，有证据表明生活方式、环境污染以及水和食物中的污染物也会产生影响。
研究西班牙一个队列中SCC与阳光暴露、污染、压力和生活方式之间的关系。
开展了一项多中心病例对照研究，2020年4月至2022年8月期间来自西班牙不同地区的13名皮肤科医生招募了病例和对照。病例组为被诊断患有SCC的患者，对照组为作为陪同前往皮肤科会诊且无皮肤癌病史的人。
共纳入62例SCC患者和126名对照（男性分别占62.9%，中位年龄76.46（10.1）岁；对照组男性占33.3%，中位年龄55.7（15）岁）。SCC组从事户外工作的经历比对照组更多（75%对22.4%，<0.001），娱乐性暴露较少（日光浴，=0.05；户外运动，=0.01），年收入较低（=0.01），烟草暴露增加（<0.001），在其他致癌物方面无差异，如电离辐射或化学暴露。对照组的每日屏幕使用时间更长（<0.001），且进行更多放松活动（=0.03）。亚麻酸摄入量较高和咖啡消费量较低是与SCC相关的仅有的饮食变量（<0.05）。一些慢性药物（抗焦虑药、抗抑郁药、β受体阻滞剂、他汀类药物、氢氯噻嗪、血管紧张素转换酶抑制剂、二甲双胍和奥美拉唑）在统计学上也与SCC相关。在多变量分析中，所有上述变量的统计学显著性均得以维持（<0.05）。
该研究发现，除了慢性阳光暴露外，西班牙人群中SCC与多种暴露组相关因素之间存在显著关联。一级预防策略应针对特定人群，如户外工作者，推广防晒行为和减压活动，此外，对于某些与SCC相关药物治疗下的患者，要进行充分的皮肤光防护。
Zotero 插件