Nading Mary Alice, Balch Charles M, Sober Arthur J
Department of Dermatology, Massachusetts General Hospital, Boston, MA 02114, USA.
Semin Cutan Med Surg. 2010 Sep;29(3):142-7. doi: 10.1016/j.sder.2010.06.004.
The Melanoma Staging and Classification system was recently revised by the American Joint Committee on Cancer (AJCC) and implemented effective January 2010 with changes reflecting new prognostic data gleaned by the significantly larger patient population studied for the 7th edition. This newest analysis yields important long-term outcome data as many of the patients were followed for nearly 2 decades. Additions to edition 7 of the AJCC Melanoma Staging classification highlight several important prognostic factors, particularly the addition of mitotic rate for classifying thin melanomas, the presence of microtumor burden in lymph nodes for stage III disease, and elevated lactate dehydrogenase levels in patients with distant metastatic disease. Although the basic tumor-nodes-metastases (ie, TNM) cancer classification model remains unchanged in this newest edition, the current AJCC Melanoma Staging System has incorporated the latest prognostic data to accurately stratify patients into staging categories. It is important for clinicians and dermatopathologists to familiarize themselves with these changes so that patients are suitably managed and referred to medical and surgical oncologists when appropriate.
美国癌症联合委员会（AJCC）最近对黑色素瘤分期和分类系统进行了修订，并于2010年1月1日起实施，修订内容反映了为第7版研究的规模显著更大的患者群体所收集的新预后数据。这项最新分析产生了重要的长期预后数据，因为许多患者被随访了近20年。AJCC黑色素瘤分期分类第7版的新增内容突出了几个重要的预后因素，特别是增加了用于对薄黑色素瘤进行分类的有丝分裂率、III期疾病淋巴结中的微肿瘤负荷以及远处转移性疾病患者中升高的乳酸脱氢酶水平。尽管在这个最新版本中基本的肿瘤-淋巴结-转移（即TNM）癌症分类模型保持不变，但当前的AJCC黑色素瘤分期系统已纳入最新的预后数据，以便将患者准确地分层到分期类别中。临床医生和皮肤病理学家熟悉这些变化很重要，这样患者才能得到适当的管理，并在适当时转诊给医学肿瘤学家和外科肿瘤学家。
