Fallowfield M E, Cook M G
Department of Histopathology, St George's Hospital Medical School, London, UK.
Histopathology. 1990 Nov;17(5):397-400. doi: 10.1111/j.1365-2559.1990.tb00758.x.
The presence of a field change, affecting epidermal melanocytes in the skin surrounding melanomas, has been cited as a justification for performing radical excision of these lesions. Twenty-five consecutive re-excisions of melanoma specimens were examined and melanocytes per 100 keratinocytes counted continuously across the width of each, in order to ascertain whether melanocyte counts decreased from the centre to the periphery, as would be expected if there were a field change effect associated with the tumour. Melanocyte counts did not appear to diminish with increasing distance from the tumour site and were within the range seen in a previous study in which we demonstrated increased numbers of basal melanocytes and melanocyte atypia in sun-exposed skin from a control population. Melanocyte atypia of a mild degree was present in five of the 25 cases studied, but in no case was this greater than that observed in sun-exposed forearm skin. We therefore suggest that the 'field change effect' in epidermal melanocytes adjacent to melanoma could be a result of chronic sun exposure alone.
有研究称，黑色素瘤周围皮肤中的表皮黑素细胞出现场效应改变，这被视为对这些病变进行根治性切除的依据。我们连续检查了25例黑色素瘤标本的再次切除组织，并在每个标本的宽度上连续计数每100个角质形成细胞中的黑素细胞数量，以确定黑素细胞计数是否从中心到周边减少，这是如果存在与肿瘤相关的场效应改变时所预期的情况。黑素细胞计数似乎并未随着与肿瘤部位距离的增加而减少，且处于我们之前一项研究中所观察到的范围内，在该研究中，我们证明了来自对照人群的暴露于阳光下的皮肤中基底黑素细胞数量增加以及黑素细胞异型性增加。在研究的25例病例中，有5例存在轻度黑素细胞异型性，但在任何病例中，这种异型性都不大于在暴露于阳光下的前臂皮肤中观察到的情况。因此，我们认为，黑色素瘤邻近的表皮黑素细胞中的“场效应改变”可能仅是长期阳光照射的结果。
