The emergence of systemic therapies and photoprotection against non-melanoma skin cancer (NMSC) raises questions on the broader systematic impact of the disease. Personalized medicine involves a holistic patient approach, through which the evaluation of systemic biomarkers can reveal the interconnected aspects of patient health and tailored therapies. Cumulative UV exposure disrupts redox equilibrium and triggers inflammation and cutaneous immunosuppression, processes that contribute independently or via their interplay to cutaneous carcinogenesis. This systemic impact can be further reinforced by biomolecules derived from the NMSC microenvironment, fueling a continuous cycle of oxidative stress and inflammation in the organism. Regarding investigation of the systemic burden of NMSC, we conducted a narrative review focusing on parameters related to redox status, inflammation, and immune suppression observed in the blood components (serum, plasma, and erythrocytes) of NMSC patients. Our findings revealed an association of NMSC patients with perturbations of redox homeostasis, as evidenced by the decreased antioxidant activity, lower levels of non-enzymatic antioxidants, and increased byproducts of lipid, protein, and DNA oxidative damage. Additionally, NMSC patients presented augmented levels of pro-inflammatory interleukins, reduced anti-tumor biomolecule levels, and enhanced immune response markers, as well as elevated vitamin D levels. These systemic changes may lead to the association of NMSC with a higher risk of secondary malignancies in other organs. Overall, the findings of the present study suggest that NMSC affects systemic health beyond the skin, underscoring the need for a comprehensive and individualized approach to the management and monitoring of the patient.
针对非黑色素瘤皮肤癌（NMSC）的系统性治疗和光防护措施的出现，引发了关于该疾病更广泛系统性影响的思考。个体化医疗强调对患者采取整体性诊疗策略，通过评估系统性生物标志物，可以揭示患者健康状况的相互关联性以及定制化治疗方案。长期累积的紫外线暴露会破坏氧化还原平衡，引发炎症反应和皮肤免疫抑制，这些过程单独或相互作用共同促进皮肤癌的发生发展。源自NMSC微环境的生物分子可能进一步加剧这种系统性影响，在机体内形成氧化应激与炎症的持续循环。为探究NMSC的系统性负担，我们进行了叙述性综述，重点关注NMSC患者血液成分（血清、血浆和红细胞）中与氧化还原状态、炎症及免疫抑制相关的参数。研究结果显示，NMSC患者存在氧化还原稳态紊乱，具体表现为抗氧化活性降低、非酶类抗氧化剂水平下降，以及脂质、蛋白质和DNA氧化损伤副产物增加。此外，NMSC患者表现出促炎性白细胞介素水平升高、抗肿瘤生物分子水平降低、免疫应答标志物增强以及维生素D水平上升。这些系统性改变可能导致NMSC与其他器官继发性恶性肿瘤风险升高相关。总体而言，本研究结果表明NMSC的影响超越皮肤范畴而波及全身健康，这强调了对患者进行综合性和个体化管理与监测的必要性。
Non-Melanoma Skin Cancer: Assessing the Systemic Burden of the Disease
肿瘤(癌症)患者之家