Bonfá Raquel, Bonamigo Renan Rangel, Bonfá Rafael, Duro Kauê Marcolin, Furian Roque Domingos, Zelmanowicz Alice de Medeiros
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
An Bras Dermatol. 2011 Mar-Apr;86(2):215-21. doi: 10.1590/s0365-05962011000200003.
The incidence of melanoma cutaneous and the mortalities rates are rising in most countries worldwide.
to describe the histopathological characteristics of cutaneous melanoma, according to the criteria established by the Brazilian Group of Melanoma, and to evaluate early diagnosis in a cancer treatment referral center.
we performed a cross-sectional descriptive study of cases of primary cutaneous melanoma identified after excisional biopsy and processed at the pathology laboratory of Complexo Hospitalar Santa Casa between Jan 1st 2000 and Jan 15th 2005. The following variables were analyzed: age, gender, topography, histopathologic subtype, Breslow thickness, growth phase, Clark level, mitotic index, peritumoral and intratumoral lymphocytic inflammatory infiltrate, angiolymphatic invasion, ulceration, regression, type of regression, microscopic satellitosis, and surgical margins.
328 cases, 57% female and 43% male, were analyzed. Mean age was 55.6 years. For women, the most common tumor location was in inferior(29.26%) and superior limbs(23.94%), while for men melanoma was mainly found in the back(35%), followed by anterior chest/abdomen(14.29%) (p<0.05). Prevalence of histologic subtypes was the following: superficial spreading melanoma(62.8%), lentigo maligna(14.9%), nodular(14.6%), acral(7.3%), and desmoplastic(0.3%) types. Regarding Breslow, 26.2% were in situ, 36.9% had <1 mm, and only 15.9% were ? 4mm in depth.
the distribution of histopathologic subtypes, as well as Breslow thickness, was in accordance with previous studies in outpatient populations. The profile of cases of cutaneous melanoma diagnosed in a tertiary hospital seems to be experiencing some changes over the last two decades, with a current trend for earlier diagnosis.
全球大多数国家皮肤黑色素瘤的发病率和死亡率都在上升。
根据巴西黑色素瘤研究小组制定的标准，描述皮肤黑色素瘤的组织病理学特征，并在一家癌症治疗转诊中心评估早期诊断情况。
我们对2000年1月1日至2005年1月15日期间在圣卡塔琳娜综合医院病理实验室经切除活检确诊并处理的原发性皮肤黑色素瘤病例进行了横断面描述性研究。分析了以下变量：年龄、性别、部位、组织病理学亚型、 Breslow厚度、生长阶段、Clark分级、有丝分裂指数、肿瘤周围和肿瘤内淋巴细胞炎性浸润、血管淋巴管侵犯、溃疡、消退、消退类型、微小卫星灶和手术切缘。
共分析了328例病例，女性占57%，男性占43%。平均年龄为55.6岁。女性中，最常见的肿瘤部位是下肢（29.26%）和上肢（23.94%），而男性黑色素瘤主要位于背部（35%），其次是前胸/腹部（14.29%）（p<0.05）。组织学亚型的患病率如下：浅表扩散型黑色素瘤（62.8%）、恶性雀斑样痣（14.9%）、结节型（14.6%）、肢端型（7.3%）和促纤维增生型（0.3%）。关于Breslow厚度，26.2%为原位癌，36.9%厚度<1mm，只有15.9%深度≥4mm。
组织病理学亚型的分布以及Breslow厚度与先前门诊人群的研究结果一致。在过去二十年中，三级医院诊断的皮肤黑色素瘤病例情况似乎正在发生一些变化，目前有早期诊断的趋势。
