来自澳大利亚昆士兰一个基于人群的癌症登记处的薄型和厚型结节性黑色素瘤呈现相关因素。

Factors related to the presentation of thin and thick nodular melanoma from a population-based cancer registry in Queensland Australia.

作者信息

Geller Alan C, Elwood Mark, Swetter Susan M, Brooks Daniel R, Aitken Joanne, Youl Philippa H, Demierre Marie-France, Baade Peter D

机构信息

Division of Public Health Practice, Harvard School of Public Health, Boston, Massachusetts 02215, USA.

出版信息

Cancer. 2009 Mar 15;115(6):1318-27. doi: 10.1002/cncr.24162.

DOI:10.1002/cncr.24162

PMID:19189368

Abstract

BACKGROUND

Worldwide, the incidence of thick melanoma has not declined, and the nodular melanoma (NM) subtype accounts for nearly 40% of newly diagnosed thick melanoma. To assess differences between patients with thin (<or=2.00 mm) and thick (>or=2.01 mm) nodular melanoma, the authors evaluated factors such as demographics, melanoma detection patterns, tumor visibility, and physician screening for NM alone and compared clinical presentation and anatomic location of NM with superficial spreading melanoma (SSM).

METHODS

The authors used data from a large population-based study of Queensland (Australia) residents diagnosed with melanoma. Queensland residents aged 20 to 75 years with histologically confirmed first primary invasive cutaneous melanoma were eligible for the study, and all questionnaires were conducted by telephone (response rate, 77.9%).

RESULTS

During this 4-year period, 369 patients with nodular melanoma were interviewed, of whom 56.7% were diagnosed with tumors <or=2.00 mm. Men, older individuals, and those who had not been screened by a physician in the past 3 years were more likely to have nodular tumors of greater thickness. Thickest nodular melanoma (4 mm+) was also most common in persons who had not been screened by a physician within the past 3 years (odds ratio, 3.75; 95% confidence interval, 1.47-9.59). Forty-six percent of patients with thin nodular melanoma (<or=2.00 mm) reported a change in color, compared with 64% of patients with thin SSM and 26% of patients with thick nodular melanoma (>2.00 mm).

CONCLUSIONS

Awareness of factors related to earlier detection of potentially fatal nodular melanomas, including the benefits of a physician examination, should be useful in enhancing public and professional education strategies. Particular awareness of clinical warning signs associated with thin nodular melanoma should allow for more prompt diagnosis and treatment of this subtype.

摘要

背景

在全球范围内，厚皮黑色素瘤的发病率并未下降，结节性黑色素瘤（NM）亚型占新诊断出的厚皮黑色素瘤的近40%。为评估薄型（≤2.00 mm）和厚型（≥2.01 mm）结节性黑色素瘤患者之间的差异，作者评估了人口统计学、黑色素瘤检测模式、肿瘤可见性以及仅针对NM的医生筛查等因素，并比较了NM与浅表扩散性黑色素瘤（SSM）的临床表现和解剖位置。

方法

作者使用了一项对澳大利亚昆士兰居民进行的基于人群的大型黑色素瘤研究的数据。年龄在20至75岁、经组织学确诊为原发性侵袭性皮肤黑色素瘤的昆士兰居民符合该研究条件，所有问卷调查均通过电话进行（应答率为77.9%）。

结果

在这4年期间，对369例结节性黑色素瘤患者进行了访谈，其中56.7%被诊断为肿瘤≤2.00 mm。男性、年龄较大者以及在过去3年中未接受医生筛查的人更有可能患有厚度更大的结节性肿瘤。最厚的结节性黑色素瘤（4 mm及以上）在过去3年内未接受医生筛查的人群中也最为常见（优势比为3.75；95%置信区间为1.47 - 9.59）。46%的薄型结节性黑色素瘤（≤2.00 mm）患者报告有颜色变化，相比之下，薄型SSM患者中有64%以及厚型结节性黑色素瘤（>2.00 mm）患者中有26%报告有颜色变化。