Lear J T, Tan B B, Smith A G, Jones P W, Heagerty A H, Strange R C, Fryer A A
Department of Dermatology, North Staffordshire Hospital, Stoke-on-Trent, UK.
Int J Clin Pract. 1998 Apr-May;52(3):145-9.
Cutaneous malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) exhibit markedly different natural histories, but few studies have compared risk factors in individuals from a single population. Using logistic regression analysis in case and control groups, we assessed, the association of individual characteristics with MM (n = 240) and SCC (n = 184). We also compared differences in risk factors (eye/hair colour, skin type, smoking history, occupation, social class, tumour site) between MM/BCC and SCC/BCC. MM patients were more likely to have red/blonde hair and blue/green eyes than controls, and those with SCC more likely to have red/blonde hair, blue/green eyes, outdoor occupation, skin type 1 and to have smoked more. There were few differences in individual characteristics between the skin cancer groups, illustrating their non-specific nature. Tumour site, however, showed marked differences: MM patients were more likely to have a tumour on the trunk or limbs than BCC patients, while patients with SCC were more likely to have a tumour on the limbs. Reasons for this variation are unclear. The relatively weak effect of individual factors supports the view of a multifactorial disease and suggests that interactions between UV exposure and genetic predisposition may be more significant determinants of risk.
皮肤恶性黑色素瘤(MM)、鳞状细胞癌(SCC)和基底细胞癌(BCC)具有明显不同的自然病史,但很少有研究在单一人群个体中比较风险因素。通过对病例组和对照组进行逻辑回归分析,我们评估了个体特征与MM(n = 240)和SCC(n = 184)的关联。我们还比较了MM/BCC和SCC/BCC之间风险因素(眼睛/头发颜色、皮肤类型、吸烟史、职业、社会阶层、肿瘤部位)的差异。与对照组相比,MM患者更易有红色/金色头发和蓝色/绿色眼睛,而SCC患者更易有红色/金色头发、蓝色/绿色眼睛、户外职业、1型皮肤且吸烟更多。皮肤癌组之间个体特征差异不大,表明其非特异性。然而,肿瘤部位显示出明显差异:MM患者比BCC患者更易在躯干或四肢出现肿瘤,而SCC患者更易在四肢出现肿瘤。这种差异的原因尚不清楚。个体因素的相对较弱影响支持了多因素疾病的观点,并表明紫外线暴露与遗传易感性之间的相互作用可能是更重要的风险决定因素。