Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Clin Transl Oncol. 2012 Mar;14(3):237-40. doi: 10.1007/s12094-012-0790-6.
Histological ulceration in cutaneous melanoma carries a high risk of metastasis and has a poor prognosis. However, some epidemiological and survival studies of patients with cutaneous melanoma do not consider histological ulceration as one of the main prognostic factors.
Epidemiological, clinical, histological and survival characteristics of all patients diagnosed with cutaneous melanoma over a 10-year period (1994- 2003) were retrospectively analysed.
Ulcerated melanoma was observed in 77 of 423 patients (18.2%). Ulceration was significantly associated with male sex, deeper tumour thickness, positive sentinel lymph node biopsy and metastasis (p<0.001). Histological ulceration indicates a high relative risk (RR) of death from melanoma (RR 9.41; 95% CI 4.52-19.59) and a significant risk of metastasis (RR 5.72; 95% CI 3.56-9.19) (p<0.001).
Histological ulceration is associated with lower overall survival and disease-free survival in patients with cutaneous melanoma. Presence of ulceration must be included in the clinical history of patients with melanoma to ensure a careful diagnostic work-up and follow-up.
皮肤黑色素瘤的组织学溃疡具有很高的转移风险和不良预后。然而，一些皮肤黑色素瘤患者的流行病学和生存研究并没有将组织学溃疡作为主要预后因素之一。
回顾性分析了 1994 年至 2003 年期间诊断为皮肤黑色素瘤的所有患者的流行病学、临床、组织学和生存特征。
在 423 名患者中有 77 名（18.2%）出现溃疡性黑色素瘤。溃疡与男性、肿瘤厚度较深、前哨淋巴结活检阳性和转移显著相关（p<0.001）。组织学溃疡表明黑色素瘤死亡的相对风险（RR）较高（RR 9.41；95%CI 4.52-19.59），转移风险显著增加（RR 5.72；95%CI 3.56-9.19）（p<0.001）。
组织学溃疡与皮肤黑色素瘤患者的总生存率和无病生存率降低有关。溃疡的存在必须包含在黑色素瘤患者的临床病史中，以确保进行仔细的诊断检查和随访。
