Risk of Squamous Cell Carcinoma of the Skin in Relation to IgE: A Nested Case-Control Study
Cette étude (112 cas et 227 témoins) évalue la relation entre IgE, un marqueur de la fonction immunitaire associé aux allergies atopiques, et le risque de carcinome spinocellulaire
Background: Individuals diagnosed with non-melanoma skin cancer have a high risk of developing a second skin cancer diagnosis. We assessed whether a marker of immune function related to atopic allergy, IgE, was associated with diagnosis of subsequent squamous cell carcinoma (SCC) of the skin in patients with a previous skin cancer enrolled in a skin cancer prevention trial. Methods: One hundred twelve cases with a repeat skin cancer diagnosis were compared to 227 controls, matched on age, sex, and study center. Total, respiratory, and food-specific IgE were measured in the baseline or year one (prior to diagnosis) sera samples for each subject. Results: IgE levels were higher in cases with a second SCC than controls (comparing the highest quartile to the lowest, ORtotal IgE=1.44; 95% CI:0.73-2.85; ORrespiratory IgE =2.43; 95% CI:1.16-5.06; ORfood IgE =2.53; 95%CI:1.19-5.35). The association between respiratory IgE and subsequent skin cancer was strongest among individuals with a tendency to sunburn (ORrespiratory IgE =3.82; 95%CI: 1.05-13.88) compared with those with a tendency to tan (ORrespiratory IgE = 0.95; 95%CI:0.20-4.76). Among 25 subjects with repeat IgE measurements taken over several years, IgE levels were remarkably stable (interclass coefficient = 0.90 for total IgE). Conclusions: These results indicate that allergy or allergy-associated IgE may be indicative of an immune phenotype that enhances risk of SCC, possibly via immune-associate inflammatory mediators. Impact: Our results indicate that controlling allergy and IgE levels may be a new avenue of skin cancer prevention in susceptible populations, and implicate immune mechanisms in skin carcinogenesis.