Department of Public Health, University of Turin, Turin, Italy.
Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy.
Br J Dermatol. 2018 Feb;178(2):357-362. doi: 10.1111/bjd.15552. Epub 2017 Nov 15.
The prognostic significance of histological regression in primary melanoma has been debated for many years. We aim to review the evidence to see how histological regression may affect prognosis. A systematic review was performed by searching in MEDLINE, Scopus and the Cochrane Library from 1 January 1966 to 1 August 2015. All studies reporting hazard ratios or data on survival and histological regression were included. Primary random-effects meta-analyses were used to summarize outcome measures. Heterogeneity was assessed using the χ -test and I -statistic. To assess the potential bias of small studies we used funnel plots and the Begg and Mazumdar adjusted rank correlation method. Summaries of survival outcomes were measured as hazard ratios or relative risk of death at 5 years according to the presence of histological regression of primary melanoma. In total, 183 articles were reviewed out of 1876 retrieved. Ten studies comprising 8557 patients were included. Patients with histological regression had a lower relative risk of death (0·77, 95% confidence interval 0·61-0·97) than those without. Examination of the funnel plot did not provide evidence of publication bias. The results showed that histological regression is a protective factor for survival.
组织学消退对原发性黑素瘤的预后意义多年来一直存在争议。我们旨在回顾相关证据，探讨组织学消退对预后的影响。通过在 MEDLINE、Scopus 和 Cochrane Library 中检索，从 1966 年 1 月 1 日至 2015 年 8 月 1 日进行了系统评价。纳入了所有报告风险比或生存和组织学消退数据的研究。采用主要随机效应荟萃分析对结局指标进行汇总。采用 χ 2 检验和 I 2 统计量评估异质性。为评估小样本研究的潜在偏倚，我们使用漏斗图和 Begg 和 Mazumdar 校正秩相关法。根据原发性黑素瘤组织学消退的存在，将生存结局的汇总以 5 年死亡风险比或相对风险来衡量。共从 1876 篇文献中筛选出 183 篇进行了回顾。纳入了 10 项研究，共包含 8557 例患者。与无组织学消退的患者相比，有组织学消退的患者死亡的相对风险较低（0.77，95%置信区间 0.61-0.97）。对漏斗图的检查并未提供发表偏倚的证据。结果表明，组织学消退是生存的保护因素。
