Stierner U, Augustsson A, Rosdahl I, Suurküla M
Department of Oncology, Sahlgrenska Hospital, Göteborg, Sweden.
Melanoma Res. 1992 Jan-Feb;1(5-6):367-75. doi: 10.1097/00008390-199201000-00008.
The frequency of melanoma (CMM), and of common and dysplastic naevi (CN and DN) in areas of skin chronically, intermittently and rarely exposed to UV light was investigated in 121 melanoma patients (30-50 years) and 310 controls. Both cases and controls had significantly more CN in intermittently exposed areas than in areas chronically or rarely exposed. The ratio of observed to expected number of CMM was also highest in intermittently exposed skin (1.3 compared to 0.8 in chronically exposed and 0.5 in rarely exposed areas). Thus, intermittent UV exposure seems to have the most potent 'naevogenic' as well as carcinogenic effect on melanocytes. Nineteen per cent of controls and 56% of cases had naevi fulfilling the clinical criteria for DN. The distribution pattern of DN was clearly different from that of CN and does not accord with the idea that UV light is a major aetiological factor for DN. The probability of CMM significantly increased with the degree of relative clustering of CN (p less than 0.05) and of DN (p less than 0.01). This co-variation of naevi and CMM over the body surface might be the result of the local insults to the melanocyte system caused by UV light and/or to the fact that naevi are precursor lesions of CMM.
在121例黑色素瘤患者（30 - 50岁）和310名对照中，研究了长期、间歇性和极少暴露于紫外线区域的皮肤中黑色素瘤（CMM）以及普通和发育异常痣（CN和DN）的发生频率。病例组和对照组中间歇性暴露区域的CN均显著多于长期或极少暴露区域。CMM观察数与预期数的比值在间歇性暴露皮肤中也最高（为1.3，而长期暴露区域为0.8，极少暴露区域为0.5）。因此，间歇性紫外线暴露似乎对黑素细胞具有最强的“痣形成”以及致癌作用。19%的对照组和56%的病例组有符合DN临床标准的痣。DN的分布模式与CN明显不同，不符合紫外线是DN主要病因的观点。CMM的发生概率随CN（p<0.05）和DN（p<0.01）相对聚集程度的增加而显著升高。痣和CMM在体表的这种共同变化可能是紫外线对黑素细胞系统造成局部损伤的结果，和/或痣是CMM前驱病变这一事实的结果。
