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[可疑色素沉着性皮肤病变。普罗旺斯-阿尔卑斯-蓝色海岸地区职业医师的筛查活动]

[Suspicious pigmented skin lesions. Screening campaign by occupational physicians in the Provence-Alpes-Côte d'Azur region].

作者信息

Virey-Griffaton E, Lehucher-Michel M P, Hesse S, Chiaroni J, Roure M C, Gouvernet J, Bonérandi J J

机构信息

Service de médecine du travail, Hôpitaux de la Timone, 264, rue Saint-Pierre, 13385 Marseille.

出版信息

Presse Med. 2002 Nov 23;31(37 Pt 1):1735-8.

Abstract

OBJECTIVE

Cutaneous melanoma prevention has become a public health issue. The incidence of this cancer has been steadily growing for 50 years, and the related death ratio is not decreasing. Today, the surgical resection of a thin lesion is the only validated curative treatment. The early detection of melanoma represents a major line in the management of such tumours.

METHODS

Occupational physicians of the PACA area were invited to participate in a campaign for the screening of pigmented suspect cutaneous lesions for 2 years. Voluntary physicians were trained to use the ABCDEF diagnostic criterion. Lesions were detected during regular yearly consultations (1998/1999) and the data concerning the development and care of these lesions was collected during consultations over the following year (1999/2000).

RESULTS

Two hundred and fifty occupational physicians of the PACA area participated in the campaign. Two pre-cancerous lesions and 10 cancers (5 melanoma and 5 pigmented basocellular carcinoma) were found among the 487 suspect lesions detected. Each melanoma had a Breslow score of less than 0.9 mm and were of good or even excellent prognosis.

CONCLUSION

The cutaneous examination, although rapid, during the occupational medicine consultations, is an effective means of detecting the early onset tumoral lesions which, at that stage may potentially be cured. The ABCDEF criterion is a useful diagnostic tool and should be taught to the all the medical and paramedical staff.

摘要

目的

皮肤黑色素瘤的预防已成为一个公共卫生问题。这种癌症的发病率在50年里一直在稳步上升,且相关死亡率并未下降。如今,对薄病变进行手术切除是唯一经过验证的治愈性治疗方法。黑色素瘤的早期检测是此类肿瘤管理的一条主要途径。

方法

邀请普罗旺斯-阿尔卑斯-蓝色海岸大区(PACA)的职业医生参与一项为期两年的色素沉着可疑皮肤病变筛查活动。志愿医生接受了使用ABCDEF诊断标准的培训。病变在定期年度会诊(1998/1999年)期间被检测到,关于这些病变发展和治疗的数据在次年会诊(1999/2000年)期间收集。

结果

普罗旺斯-阿尔卑斯-蓝色海岸大区的250名职业医生参与了该活动。在检测到的487个可疑病变中,发现了2个癌前病变和10个癌症(5个黑色素瘤和5个色素性基底细胞癌)。每个黑色素瘤的 Breslow 评分均小于0.9毫米,预后良好甚至极佳。

结论

职业医学会诊期间的皮肤检查虽然快速,但却是检测早期肿瘤病变的有效手段,在那个阶段这些病变有可能被治愈。ABCDEF标准是一种有用的诊断工具,应传授给所有医疗和辅助医疗人员。

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