Wrone D A, Duncan L M, Sober A J
Departments of Dermatology and Dermatopathology, Massachusetts General Hospital, Bartlett 622, Boston, MA 02114, USA.
J Gend Specif Med. 1999 Jul-Aug;2(4):52-4.
In a question-and-discussion format, the authors summarize the major studies on melanoma and pregnancy. The laboratory studies reviewed give conflicting results; however, excellent epidemiologic studies suggest that pregnancy and melanoma are not closely linked. Specifically, the prognosis of pregnant women with melanoma is similar to the prognosis of nonpregnant women with melanoma of equal tumor thickness, and melanoma is neither more nor less likely to occur in previously pregnant women. Some studies have shown that pregnant women have melanomas that are thicker than nonpregnant women's melanomas. The reason is unclear, but it may be because malignant changes in pigmented lesions during pregnancy have been ignored. Treatment options for pregnant women with melanoma are limited, but early detection and surgical excision of thin melanomas is the goal. Changes in mole size or color during pregnancy can be normal, but all changing moles warrant careful examination, and irregular or asymmetric change is suspicious for melanoma.
作者以问答和讨论的形式总结了关于黑色素瘤与妊娠的主要研究。所回顾的实验室研究结果相互矛盾;然而,出色的流行病学研究表明妊娠与黑色素瘤并无紧密联系。具体而言,患有黑色素瘤的孕妇的预后与肿瘤厚度相同的非孕妇黑色素瘤患者的预后相似,且既往怀孕的女性发生黑色素瘤的可能性并无增减。一些研究表明,孕妇的黑色素瘤比非孕妇的黑色素瘤更厚。原因尚不清楚,但可能是因为孕期色素沉着病变的恶性变化被忽视了。患有黑色素瘤的孕妇的治疗选择有限,但早期发现并手术切除薄型黑色素瘤是目标。孕期痣大小或颜色的变化可能是正常的,但所有变化的痣都需要仔细检查,不规则或不对称的变化则怀疑为黑色素瘤。