Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium.
Int J Mol Sci. 2024 Jun 6;25(11):6251. doi: 10.3390/ijms25116251.
In this narrative review, we attempt to provide an overview of the evidence regarding the role of estrogen (receptors) in cutaneous melanoma (CM). We reviewed 68 studies and 4 systematic reviews and meta-analyses published from 2002 up to and including 2022. The prevailing presence of estrogen receptor β (ERβ) instead of estrogen receptor α (ERα) in CM is notable, with ERβ potentially playing a protective role and being less frequently detected in progressive cases. While men with CM generally experience a less favorable prognosis, this distinction may become negligible with advancing age. The role of oral contraceptives (OC) and hormone replacement therapy (HRT) in CM remains controversial. However, recent studies tend to associate the use of these exogenous hormones with a heightened risk of CM, mostly only when using estrogen therapy and not in combination with progesterone. On the contrary, the majority of studies find no substantial influence of in vitro fertilization (IVF) treatment on CM risk. Reproductive factors, including younger age at first childbirth, higher parity, and shorter reproductive life, show conflicting evidence, with some studies suggesting a lower CM risk. We suggest an important role for estrogens in CM. More research is needed, but the integration of estrogens and targeting the estrogen receptors in melanoma therapy holds promise for future developments in the field.
在这篇叙述性评论中，我们试图概述有关雌激素（受体）在皮肤黑色素瘤（CM）中作用的证据。我们回顾了 2002 年至 2022 年期间发表的 68 项研究和 4 项系统评价和荟萃分析。值得注意的是，CM 中普遍存在雌激素受体 β（ERβ）而不是雌激素受体 α（ERα），ERβ 可能发挥保护作用，在进展性病例中较少检测到。虽然男性 CM 患者的预后通常较差，但随着年龄的增长，这种差异可能变得微不足道。OC 和 HRT 在 CM 中的作用仍存在争议。然而，最近的研究倾向于将这些外源性激素的使用与 CM 风险的增加联系起来，主要是在单独使用雌激素治疗而不是与孕激素联合使用时。相反，大多数研究发现 IVF 治疗对 CM 风险没有实质性影响。生殖因素，包括首次分娩年龄较小、更高的产次和更短的生殖寿命，存在相互矛盾的证据，一些研究表明 CM 风险较低。我们提出雌激素在 CM 中的重要作用。需要进一步研究，但将雌激素整合并靶向黑色素瘤治疗中的雌激素受体，为该领域的未来发展带来了希望。
