(1) Background: Ultraviolet (UV) radiation and sunburns are associated with an increased incidence of acquired nevi and melanomas. However, the data are controversial as to whether chronic UV exposure or high intermittent UV exposure is the major carcinogenic factor in melanocytic tumors. In this study, we compared the degree of actinic elastosis (AE) as a surrogate for lifetime UV exposure in nevi and different clinical melanoma subtypes (i.e., superficial spreading melanoma (SSM), nodular malignant melanoma (NMM), acral lentiginous melanoma (ALM), and lentigo maligna melanoma (LMM)) with respect to clinical variables (age, sex, and body site). (2) Methods: We defined a semi-quantitative score for the degree of AE ranging from 0 = none to 3 = total loss of elastic fibers (basophilic degeneration) and multiplied it by the perilesional vertical extent (depth), measured histometrically (tumor-associated elastosis grade (TEG)). We matched the TEG ofn= 595 melanocytic lesions from 559 patients with their clinical variables. (3) Results: The TEG was correlated with age and UV-exposed body sites. Furthermore, the TEG was significantly higher in LMM than in all other types of melanomas and the TEG in NMM was higher than in SSM, irrespective of patient age and tumor site. (4) Conclusions: High cumulative UV exposure is more strongly associated with LMM and NMM than with other melanoma subtypes.
（1）背景：紫外线辐射与晒伤与获得性痣和黑色素瘤发病率升高相关。然而，关于慢性紫外线暴露与高强度间歇性紫外线暴露何者是黑素细胞肿瘤主要致癌因素，现有数据仍存在争议。本研究以光化性弹力纤维变性程度作为终身紫外线暴露的替代指标，比较了痣与不同临床黑色素瘤亚型（即浅表扩散性黑色素瘤、结节性恶性黑色素瘤、肢端雀斑样痣黑色素瘤和恶性雀斑样痣黑色素瘤）在临床变量（年龄、性别和身体部位）方面的差异。（2）方法：我们建立了光化性弹力纤维变性程度的半定量评分系统（0=无至3=弹力纤维完全丧失/嗜碱性变性），并将其与通过组织计量学测量的病灶周围垂直范围（深度）相乘，得出肿瘤相关弹力纤维变性分级。我们将559例患者的595个黑素细胞病变的肿瘤相关弹力纤维变性分级与其临床变量进行匹配分析。（3）结果：肿瘤相关弹力纤维变性分级与年龄和紫外线暴露部位呈正相关。此外，恶性雀斑样痣黑色素瘤的肿瘤相关弹力纤维变性分级显著高于其他所有黑色素瘤亚型，且结节性恶性黑色素瘤的分级高于浅表扩散性黑色素瘤，这种差异与患者年龄和肿瘤部位无关。（4）结论：高累积紫外线暴露与恶性雀斑样痣黑色素瘤和结节性恶性黑色素瘤的关联性强于其他黑色素瘤亚型。
肿瘤(癌症)患者之家