Rosenberg S A, Rapp H J
Med Clin North Am. 1976 May;60(3):419-30. doi: 10.1016/s0025-7125(16)31889-2.
Treatment of recurrent cutaneous melanoma nodules with BCG is an effective and relatively nonmorbid method for eliminating these tumor nodules. Injected nodules can be made to disappear about 90 per cent of the time and in about 20 per cent of patients non-injected nodules in the same drainage area may also regress. Subcutaneous melanoma nodules are far more resistant to melanoma injection. Although cutaneous nodules can be made to regress there is no evidence that a systemic effect against disseminated melanoma exists and no responses of distant visceral disease have been seen following intralesional therapy of cutaneous nodules. The regression of cutaneous nodules following BCG injection appears to be an immunologic phenomenon and is related to the immunocompetence of the patient. The molecular mechanisms of this tumor regression are unknown and are the subject of intensive study. Several new approaches such as the use of BCG for the treatment of poor prognosis primary malignant melanomas, as well as the use of nonviable, nonbacteriologic agents for intralesional treatment are under investigation.
用卡介苗治疗复发性皮肤黑色素瘤结节是一种有效且相对无严重病态的消除这些肿瘤结节的方法。注射的结节约90%的时间可消失，在约20%的患者中，同一引流区域未注射的结节也可能消退。皮下黑色素瘤结节对黑色素瘤注射的抵抗力要强得多。虽然皮肤结节可使其消退，但没有证据表明存在针对播散性黑色素瘤的全身效应，且在皮肤结节内注射治疗后未观察到远处内脏疾病有反应。卡介苗注射后皮肤结节的消退似乎是一种免疫现象，并且与患者的免疫能力有关。这种肿瘤消退的分子机制尚不清楚，是深入研究的主题。几种新方法，如使用卡介苗治疗预后不良的原发性恶性黑色素瘤，以及使用无活性、非细菌学制剂进行瘤内治疗，正在研究中。
