Ribero Simone, Davies John R, Requena Celia, Carrera Cristina, Glass Daniel, Rull Ramon, Vidal-Sicart Sergi, Vilalta Antonio, Alos Lucia, Soriano Virtudes, Quaglino Pietro, Traves Victor, Newton-Bishop Julia A, Nagore Eduardo, Malvehy Josep, Puig Susana, Bataille Veronique
Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom.
Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
Int J Cancer. 2015 Oct 1;137(7):1691-8. doi: 10.1002/ijc.29525. Epub 2015 Apr 11.
A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi.
痣的数量较多是黑色素瘤最重要的表型风险因素，且部分由基因决定。痣的数量从中年开始减少，但黑色素瘤患者的这种衰老过程可能会延迟。我们在一大群黑色素瘤病例中研究了痣数量计数对前哨淋巴结状态和黑色素瘤生存的影响。在2184例黑色素瘤病例中，684例（31.3%）痣数量较多（>50个）。尽管对年龄进行了调整，但痣数量较多与较低的Breslow厚度、较少的溃疡和较低的有丝分裂率等有利的预后因素相关。痣数量不能预测前哨淋巴结状态。痣数量较多的黑色素瘤病例的粗5年和10年黑色素瘤特异性生存率高于痣数量较少的病例（分别为91.2%对86.4%和87.2%对79%）。在对所有已知的黑色素瘤预后因素进行调整后，生存差异仍然显著（风险比[HR]=0.43，置信区间[CI]=0.21-0.89）。在前哨淋巴结阳性的患者亚组中也观察到痣数量较多具有良好的预后价值（HR=0.22，CI=0.08-0.60）。即使在前哨淋巴结阳性的患者亚组中，痣数量较多也与更好的黑色素瘤生存相关。这表明痣过多的患者中黑色素瘤肿瘤具有不同的生物学行为。
