THE FRAMINGHAM SCHOOL STUDY OF NEVI IN CHILDREN SONIC II

弗雷明汉学校对儿童《索尼克 II》中 Nevi 的研究

• 批准号: 7795907
• 负责人: ALLAN C HALPERN
• 金额: $ 74.24万
• 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 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7795907
• 关键词: 3-Dimensional; Acute; Adolescence; Adolescent; Affect; Age; Anatomic Sites; Anatomy; Back; Biology; Cessation of life; Characteristics; Child; Childhood; Classification; Clinical; Complex; Confocal Microscopy; Data; Development; Diagnosis; Dysplastic Nevus; Early Diagnosis; Education; Epidemiology; Etiology; Evolution; Excision; Face; Funding; Gender; Genetic; Genotype; Goals; Growth; Human; Image; Imaging technology; Individual; Knowledge; Lead; Learning; Leg; Lesion; Longitudinal Studies; Malignant Neoplasms; Measures; Melanocytic Neoplasm; Minority; Mole the mammal; Natural History; Neck; Nevi and Melanomas; Nevus; Nevus Cell; Pathway interactions; Pattern; Peripheral; Phenotype; Photography; Photosensitivity; Pigmentation physiologic function; Predictive Value; Prevalence; Prevention; Public Health; Research Design; Risk; Risk Marker; Sampling; Schools; Screening procedure; Site; Skin; Skin Cancer; Stratification; Students; Sun Exposure; Testing; United States; age group; arm; base; cohort; design; early adolescence; fifth grade; high risk; improved; in vivo; indexing; insight; man; melanocyte; melanoma; mortality; novel; population based; prevent; public health relevance; skin lesion; trait; tumor progression

DESCRIPTION (provided by applicant): Nevi are among the most common skin lesions in man and are critically important risk markers and potential precursors of malignant melanoma. Observations from the initial funding cycle of this project are changing our understanding of the natural history of nevi. We observed that nevus involution is common in childhood. We further observed two subsets of nevi with distinct dermoscopic patterns (globular versus reticular), that these distinct patterns remain stable in childhood, and that they have different size and anatomic distributions on the back. An additional highly novel observation in our study has been the recognition of subtle reticular and globular dermoscopic patterns in normal appearing skin that correlate with the pattern of the overlying nevi, and in the case of the globular skin pattern, correlate with the presence of previously unrecognized sub-clinical aggregates of nevus cells. Lastly, we observed that by the 5th grade a minority of children have developed nevi with a complex dermoscopic pattern. Here, we propose to build on these observations by using a longitudinal study design in an expanded sample from the same population-based cohort to test the following hypotheses: (1) Ongoing sun exposure impacts the evolution and involution of nevi in adolescence, (2) There are two dermoscopically recognizable subsets of nevi that are distinguishable based on their anatomic distribution and their differing associations with pigmentation phenotype, genotype, and presence of subclinical nevus aggregates; and (3) dermoscopically complex nevi in childhood are predictors of a high risk nevus phenotype in late adolescence. We will employ the cutting edge imaging technologies of 3- dimensional total body photography and in vivo reflectance confocal microscopy to accomplish these goals. The insights into nevus classification, etiology, and evolution gained from this study are anticipated to have significant public health, clinical, and scientific benefits. They will lead to better targeting of melanoma prevention in childhood and adolescence through improved risk stratification. These insights will also enhance studies of the biology of melanoma through the distinction of varied nevus associated pathways of melanocytic tumor progression. And, they will permit education of clinicians about the changes that routinely occur in nevi in adolescence which, in turn, should lead to a reduction of the large number of unnecessary nevus excisions in this age group. PUBLIC HEALTH RELEVANCE: Moles are potential precursors and important risk markers for malignant melanoma, the deadliest form of skin cancer. The proposed study - focused on children and adolescents - is designed to increase our understanding of different types of moles, how they evolve, and the factors that contribute to their development. The knowledge gained from this study is expected to help target melanoma prevention efforts in childhood and adolescence to those at greatest risk, to improve our understanding of how melanoma develops, and to reduce the large number of unnecessary excisions of moles that currently occur in adolescents.

描述（由申请人提供）：痣是人类最常见的皮肤病变之一，是极其重要的风险标志物和恶性黑色素瘤的潜在前兆。该项目初始资助周期的观察正在改变我们对痣自然历史的理解。我们观察到痣复旧在儿童时期很常见。我们进一步观察到两个具有不同皮肤镜模式（球状与网状）的痣子集，这些不同的模式在童年时期保持稳定，并且它们在背部具有不同的大小和解剖分布。我们的研究中另一个非常新颖的观察结果是，在正常皮肤中识别出微妙的网状和球状皮肤镜图案，这些图案与覆盖的痣的图案相关，并且在球状皮肤图案的情况下，与以前未识别的存在相关痣细胞的亚临床聚集。最后，我们观察到，到五年级时，少数儿童已经出现了具有复杂皮肤镜模式的痣。在这里，我们建议在这些观察的基础上，在来自同一人群的扩大样本中使用纵向研究设计来检验以下假设：（1）持续的阳光照射会影响青春期痣的进化和退化，（2 ) 皮肤镜下有两种可识别的痣子集，它们可以根据其解剖分布及其与色素沉着表型、基因型和亚临床痣存在的不同关联来区分聚集体； (3) 儿童时期皮肤镜下的复杂痣是青春期后期高风险痣表型的预测因子。我们将采用 3 维全身摄影和体内反射共焦显微镜的尖端成像技术来实现这些目标。从这项研究中获得的对痣分类、病因学和进化的见解预计将具有重大的公共卫生、临床和科学益处。它们将通过改进风险分层，更好地针对儿童和青少年时期的黑色素瘤预防。这些见解还将通过区分黑素细胞肿瘤进展的各种痣相关途径来加强对黑素瘤生物学的研究。而且，它们将允许对临床医生进行有关青春期痣通常发生的变化的教育，这反过来又会导致该年龄组中大量不必要的痣切除的减少。公共健康相关性：痣是恶性黑色素瘤（最致命的皮肤癌）的潜在前兆和重要风险标记。这项拟议的研究主要针对儿童和青少年，旨在增加我们对不同类型的痣、它们如何进化以及促进其发育的因素的了解。从这项研究中获得的知识预计将有助于针对儿童和青少年时期黑色素瘤风险最大的人群进行预防工作，提高我们对黑色素瘤如何发展的了解，并减少目前青少年中发生的大量不必要的痣切除。