Paul Sabatier-Toulouse III University, Toulouse, France.
Br J Dermatol. 2010 Apr;162(4):830-4. doi: 10.1111/j.1365-2133.2009.09606.x. Epub 2009 Dec 21.
Regression has been proposed as a potential marker of dissemination in thin melanomas. Previous studies have shown conflicting results.
To determine if regression in melanoma is associated with an increased risk of sentinel lymph node (SLN) metastasis.
A cohort analysis was conducted. Data on all patients were collected on a standardized case report form during 10 years. A total of 397 consecutive patients with melanoma who underwent a SLN biopsy were analysed. All cases of melanoma and SLN biopsies were examined by the same two pathologists. Differences between melanomas with and without SLN metastasis were compared using Fisher's exact test or the two-sample t-test and the chi(2) test. Multivariable logistic regression was used to adjust for possible confounding factors.
We analysed 397 patients (411 melanomas) who underwent a SLN biopsy. The median Breslow index was 1.8 mm (interquartile range 1.1-3). Regression was observed in 23% (n = 94). SLN metastases were observed in 26% (n = 106). The frequency of SLN metastasis was 16% in melanomas with regression and 29% without regression (P = 0.012). The adjusted odds ratio (OR) for regressive melanoma was 0.9 [95% confidence interval (CI) 0.4-1.9; P = 0.777]. The risk of SLN metastasis was increased in melanoma cases with a Breslow index from 1.5 to < 2.0 mm (adjusted OR 3.1; 95% CI 1.4-7.1; P = 0.006) and >or= 2.0 mm (adjusted OR 3.5; 95% CI 1.7-7.4; P = 0.001) and ulceration of the melanoma (adjusted OR 1.8; 95% CI 1.1-3.2; P = 0.03).
Regression is not an independent predictor of the risk of SLN metastasis in melanoma.
后退被认为是薄型黑素瘤扩散的一个潜在标志物。之前的研究结果不一。
确定黑素瘤中的后退是否与前哨淋巴结（SLN）转移的风险增加相关。
进行了队列分析。在 10 年内，通过标准化病例报告表收集了所有患者的数据。共分析了 397 例连续接受 SLN 活检的黑素瘤患者。所有黑素瘤和 SLN 活检均由同两名病理学家进行检查。使用 Fisher 确切检验或两样本 t 检验和卡方检验比较有和无 SLN 转移的黑素瘤之间的差异。使用多变量逻辑回归来调整可能的混杂因素。
我们分析了 397 例（411 个黑素瘤）接受 SLN 活检的患者。Breslow 指数的中位数为 1.8mm（四分位间距 1.1-3）。观察到 23%（n=94）的黑素瘤有后退。SLN 转移的发生率为 26%（n=106）。后退黑素瘤的 SLN 转移率为 16%，无后退黑素瘤的 SLN 转移率为 29%（P=0.012）。后退黑素瘤的调整后比值比（OR）为 0.9（95%置信区间 0.4-1.9；P=0.777）。Breslow 指数为 1.5-<2.0mm（调整后 OR 3.1；95%置信区间 1.4-7.1；P=0.006）和≥2.0mm（调整后 OR 3.5；95%置信区间 1.7-7.4；P=0.001）的黑素瘤病例以及黑素瘤溃疡（调整后 OR 1.8；95%置信区间 1.1-3.2；P=0.03）的 SLN 转移风险增加。
后退不是黑素瘤 SLN 转移风险的独立预测因子。
