Asquith P R, Barnett J M, Lockett B K
General Surgery, Palmerston North Hospital.
N Z Med J. 1999 Aug 27;112(1094):313-6.
To investigate changes in incidence of in-situ, 'thin' (< 0.76 mm) and 'thick' (> 0.76 mm) melanoma. To explore the relationship of melanoma depth with the patient's age at diagnosis.
A retrospective case series of melanoma was taken from pathology records in Palmerston North between 1983 and 1994. The denominator population was estimated, for each year, from published 1986 and 1991 census figures.
Over the 12 years, the diagnostic rate of in-situ and invasive melanomas increased annually by 16% and 5%, respectively (Poisson regression, p < 0.0001). This analysis did not show a difference between the overall rate of increase in 'thin' and 'thick' invasive melanomas. After excluding Hutchinson's melanoma, the mean age at diagnosis for 'thin' and 'thick' melanomas was 49.0 and 55.4 years, respectively (p < 0.0001); the peak number of 'thin' and 'thick' melanomas were in the 30-39 and 60-69 age groups, respectively.
There is evidence for progression from 'thin' to 'thick' melanoma over a 6-to 30-year period. Poor prognosis 'thick' melanomas are currently increasing. Providing removal of 'thin' melanomas is sustained, a decline in 'thick' melanomas is expected but may take decades.
调查原位、“薄”（<0.76毫米）及“厚”（>0.76毫米）黑色素瘤的发病率变化。探讨黑色素瘤深度与患者确诊时年龄的关系。
对1983年至1994年在北帕默斯顿的病理记录进行黑色素瘤回顾性病例系列研究。每年根据1986年和1991年公布的人口普查数据估算分母人群。
在这12年中，原位和侵袭性黑色素瘤的诊断率分别以每年16%和5%的速度上升（泊松回归，p<0.0001）。该分析未显示“薄”和“厚”侵袭性黑色素瘤的总体增长率存在差异。排除哈钦森黑色素瘤后，“薄”和“厚”黑色素瘤确诊时的平均年龄分别为49.0岁和55.4岁（p<0.0001）；“薄”和“厚”黑色素瘤的发病高峰分别在30 - 39岁和60 - 69岁年龄组。
有证据表明在6至30年期间黑色素瘤会从“薄”向“厚”发展。预后较差的“厚”黑色素瘤目前正在增加。如果能持续切除“薄”黑色素瘤，预计“厚”黑色素瘤的发病率会下降，但可能需要数十年时间。
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