Drzewiecki K T, Frydman H, Andersen K, Poulsen H, Ladefoged C, Vibe P
Department of Plastic Surgery, Rigshospitalet, Copenhagen, Denmark.
Cancer. 1990 Jan 15;65(2):362-6. doi: 10.1002/1097-0142(19900115)65:2<362::aid-cncr2820650231>3.0.co;2-e.
Seven hundred fourteen patients with cutaneous melanoma in clinical Stage I treated between 1964 and 1982 were included in this study. In an analysis of metastasis-free survival, thickness of the tumor, ulceration, gender, epithelioid cells as predominant cells in the tumor, and localization of the tumor were found to be independent prognostic factors. In a time trends analysis, the distributions of three of the prognostic factors (thickness of the tumor, ulceration, and inflammatory cell infiltrate) were found to shift during the last decade in the direction of improved prognosis, indicating that tumors are detected earlier than before. The distributions of two other factors (cell type and location of the tumors) shifted in the direction of deteriorated prognosis, suggesting partly that the biologic nature of the disease may have changed and partly that other behavioral factors may have played a role.
本研究纳入了1964年至1982年间接受治疗的714例临床I期皮肤黑色素瘤患者。在无转移生存期分析中，发现肿瘤厚度、溃疡、性别、肿瘤中以上皮样细胞为主以及肿瘤定位是独立的预后因素。在时间趋势分析中，发现其中三个预后因素（肿瘤厚度、溃疡和炎性细胞浸润）的分布在过去十年中朝着预后改善的方向转变，这表明肿瘤比以前更早被发现。另外两个因素（细胞类型和肿瘤位置）的分布朝着预后恶化的方向转变，部分表明疾病的生物学性质可能发生了变化，部分表明其他行为因素可能起到了作用。
