Masri G D, Clark W H, Guerry D, Halpern A, Thompson C J, Elder D E
Department of Medicine, Johns Hopkins Medical Institutions.
J Am Acad Dermatol. 1990 Jun;22(6 Pt 1):1042-8. doi: 10.1016/0190-9622(90)70149-c.
Screening, surveillance, and educational programs have been recommended for members of hereditary melanoma kindreds with dysplastic nevi, who are at very high risk for melanoma. For melanomas detected in a surveillance program offered to 555 such persons, the average thickness was 0.52 mm for 28 surveillance incident melanomas, 0.55 mm for 64 nonsurveillance incident melanomas, and 1.44 mm for 48 index lesions (p less than 0.001). The proportion of cases with level I or II invasion was 60.8%, 58.3%, and 36.2% respectively (p = 0.002). The nonsurveillance incident melanomas were diagnosed before entry into the surveillance program, but these patients were presumably aware of the earlier occurrence of two index melanomas in their families. These findings are consistent with a favorable effect of surveillance and education in a high-risk population and suggest that patient factors as well as physician factors may contribute to early diagnosis.
对于患有发育异常痣且患黑色素瘤风险极高的遗传性黑色素瘤家族成员，推荐进行筛查、监测和教育项目。在为555名此类人员提供的监测项目中检测到的黑色素瘤，28例监测期新发黑色素瘤的平均厚度为0.52毫米，64例非监测期新发黑色素瘤的平均厚度为0.55毫米，48例原发损害的平均厚度为1.44毫米（p<0.001）。I级或II级浸润病例的比例分别为60.8%、58.3%和36.2%（p = 0.002）。非监测期新发黑色素瘤是在进入监测项目之前被诊断出来的，但这些患者可能已经知晓其家族中早期出现过两例原发黑色素瘤。这些发现与监测和教育在高危人群中产生的良好效果一致，并表明患者因素以及医生因素可能有助于早期诊断。
