Seykora J, Elder D
Pigmented Lesion Study Group, University of Pennsylvania School of Medicine, Philadelphia, USA.
Semin Oncol. 1996 Dec;23(6):682-7.
Risk markers for cancer are genetic or behavioral attributes that are statistically associated with increased incidence of cancer. Risk may be assessed either in case-control studies, or in cohort studies in which individuals with particular attributes are followed and cancer risk is determined by direct observation. Both of these methods have been used to determine the major risk markers for melanoma. The single most important risk marker is the presence on the skin of dysplastic nevi. Dysplastic nevi may be regarded as intermediate lesions of tumor progression, in that approximately 30% of melanomas arise in association with a precursor nevus, which is most commonly dysplastic. However, paradoxically, because they are vastly more numerous than melanoma, most dysplastic nevi are stable lesions that do not progress. Additional important melanoma risk factors include a family and/or personal history of melanoma. A third major category of risk markers includes indicators of acute and chronic exposure to the sun, including freckles, actinic skin damage, and a history of sunburn. Evaluation of these markers in oncological patients and their first-degree relatives can identify a population of individuals whose risk for melanoma ranges from several-fold to more than 100-fold greater than that of random population members. Efforts directed at early diagnosis in these individuals can result in recognition of melanomas in their early, curable stages.
癌症风险标志物是与癌症发病率增加在统计学上相关的遗传或行为属性。风险可以在病例对照研究中评估，也可以在队列研究中评估，在队列研究中，对具有特定属性的个体进行随访，并通过直接观察确定癌症风险。这两种方法都已被用于确定黑色素瘤的主要风险标志物。最重要的单一风险标志物是发育异常痣在皮肤上的存在。发育异常痣可被视为肿瘤进展的中间病变，因为大约30%的黑色素瘤与前驱痣相关，最常见的是发育异常痣。然而，矛盾的是，由于发育异常痣比黑色素瘤多得多，大多数发育异常痣是稳定的病变，不会进展。其他重要的黑色素瘤风险因素包括黑色素瘤的家族史和/或个人史。第三大类风险标志物包括急性和慢性日晒的指标，包括雀斑、光化性皮肤损伤和晒伤史。对肿瘤患者及其一级亲属的这些标志物进行评估，可以识别出一群黑色素瘤风险比随机人群高出几倍至100多倍的个体。针对这些个体进行早期诊断的努力可以在黑色素瘤的早期可治愈阶段识别出它们。
