The Framingham School Nevus Study

弗雷明汉学校痣研究

• 批准号: 6950031
• 负责人: ALLAN C HALPERN
• 金额: $ 52.69万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-26 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6950031
• 关键词: adolescence (12-20); cancer risk; child (0-11); clinical research; human subject; longitudinal human study; melanoma; nonvisual photosensitivity; photography; pigmented nevus; solar radiation

DESCRIPTION (provided by applicant): Nevi (moles) are important precursors and risk markers for melanoma. Current knowledge, derived largely from cross-sectional studies, indicates that adolescence is a critical period for the appearance and evolution f nevi. There is further compelling evidence that nevus phenotype is largely genetically determined with a significant modifying effect of sun exposure. The primary objective of this study is to evaluate specific genetic and environmental factors as risk factors for nevus development and growth in early adolescence. A secondary aim is to document the clinical and dermoscopic evolution of individual nevi in this age group. We will apply a combined cross-sectional and longitudinal study design to the cohort of all consenting 5th graders in the Framingham, Massachusetts school system (estimated n=735) to address three aims. Aim #1 utilizes a cross-sectional study of the 5th grade students to test the hypothesis that germline melanocortin receptor (MC1 R) variants, intense childhood sun exposure, and lack of sun protection in childhood are associated with increased numbers of nevi and large nevi in early adolescence. Aim #2 applies a longitudinal study design in the same student population followed through 8th grade to test the hypothesis that MC1R variants, ongoing intense sun exposure, and ongoing lack of sun protection are associated with increased numbers and increased size of nevi during adolescence. Aim #3 utilizes digital photography and dermoscopy, a recently developed imaging technique, to document the clinical and subsurface appearance and evolution of common nevi in the cohort under study. We will use parent and child surveys conducted at baseline and repeated annually to ascertain sun sensitivity, childhood sun exposure and current sun exposure. We will conduct examinations of the skin of the back including high resolution overview photography and close up digital photography and digital dermoscopy of four index nevi at baseline (5th grade) and repeated in 8th grade to document pigmentary phenotype, the prevalence of nevi by size, the incidence of new and changed nevi, and the clinical and dermoscopic features of individual nevi. Mouthwash derived DNA collected at the baseline examination will be used for MC1R genotyping. The insights into nevus risk factors and evolution gleaned from this study will have significant implications for reduction of melanoma mortality through improved risk stratification and more informed prevention.

描述（由申请人提供）： 痣是黑色素瘤的重要前兆和风险标记。目前的知识主要来自横断面研究，表明青春期是痣出现和演变的关键时期。还有进一步令人信服的证据表明，痣表型很大程度上是由基因决定的，阳光照射具有显着的改变作用。本研究的主要目的是评估特定的遗传和环境因素作为青春期早期痣发育和生长的危险因素。第二个目的是记录该年龄段个体痣的临床和皮肤镜演变。我们将对马萨诸塞州弗雷明汉学校系统中所有同意的五年级学生（估计 n=735）应用横断面和纵向相结合的研究设计，以实现三个目标。目标 #1 利用五年级学生的横断面研究来检验以下假设：种系黑皮质素受体 (MC1 R) 变异、儿童时期强烈的阳光照射以及儿童时期缺乏防晒措施与痣和大痣数量增加有关在青春期早期。目标 #2 在相同的学生群体中应用了纵向研究设计，一直持续到八年级，以检验以下假设：MC1R 变异、持续强烈的阳光照射和持续缺乏防晒措施与青春期痣数量和大小的增加有关。目标#3利用数码摄影和皮肤镜检查（一种最近开发的成像技术）来记录研究队列中常见痣的临床和皮下外观以及演变。我们将使用在基线上进行并每年重复进行的家长和儿童调查来确定阳光敏感性、儿童时期的阳光照射量和当前的阳光照射量。我们将对背部皮肤进行检查，包括基线（五年级）的四个指数痣的高分辨率概览摄影和特写数码摄影和数字皮肤镜检查，并在八年级重复进行，以记录色素表型、按大小划分的痣的患病率、新的和改变的痣的发生率，以及个体痣的临床和皮肤镜特征。基线检查时收集的漱口水衍生 DNA 将用于 MC1R 基因分型。从这项研究中收集到的对痣危险因素和演变的见解将通过改进风险分层和更明智的预防来降低黑色素瘤死亡率具有重大意义。