Sheen Yi-Shuan, Liao Yi-Hua, Lin Ming-Hsien, Chen Jau-Shiuh, Liau Jau-Yu, Liang Cher-Wei, Chang Yih-Leong, Chu Chia-Yu
Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
PLoS One. 2017 May 4;12(5):e0177126. doi: 10.1371/journal.pone.0177126. eCollection 2017.
Studies surveying melanomas associated with melanocytic nevi in Asia are rare. In this study, we examined whether nevus-associated melanomas differ from de novo melanomas in terms of their associations with clinical factors, histologic characteristics, and patient survival in Taiwan. Using data on cancer cases obtained from the Department of Pathology archives and the Cancer Registry of National Taiwan University Hospital, we conducted a retrospective analysis of 103 consecutive melanoma patients who were diagnosed between 2010 and 2015 and received follow-up through November 2016. Approximately 17.5% of the melanomas in question were associated with a nevus. In patients under 65 years of age, non-acral lentiginous melanomas were significantly associated with a higher percentage of nevus-associated melanomas. The superficial spreading subtype, younger patient age, thinner tumor, intermittent solar exposure, and early stage were significant predictors of a melanoma being histologically associated with a nevus. The appearance of a nevus associated with a melanoma predicted better recurrence-free survival compared with de novo melanomas. Although acral lentiginous melanomas (70.9%) constituted the most common histologic subtype, only 9.6% of the acral lentiginous melanomas were associated with a nevus. Furthermore, there was no statistically significant difference between the nevus-associated and de novo acral lentiginous melanomas with regard to clinicopathological factors and survival. In conclusion, nevus-associated melanomas were uncommon among acral lentiginous melanomas. Relatedly, because over half of all melanomas in Asians are acral lentiginous melanomas, Asians are less likely than Caucasians to have nevus-associated melanomas.
在亚洲，针对与黑素细胞痣相关的黑色素瘤的研究很少。在本研究中，我们调查了台湾地区与痣相关的黑色素瘤在临床因素、组织学特征及患者生存率方面是否与新发黑色素瘤存在差异。利用从国立台湾大学医院病理档案部和癌症登记处获取的癌症病例数据，我们对2010年至2015年间确诊且截至2016年11月接受随访的103例连续黑色素瘤患者进行了回顾性分析。约17.5%的相关黑色素瘤与痣有关。在65岁以下患者中，非肢端雀斑样痣黑色素瘤与痣相关黑色素瘤的比例显著更高。浅表扩散亚型、患者年龄较轻、肿瘤较薄、间歇性日晒及早期阶段是黑色素瘤在组织学上与痣相关的显著预测因素。与新发黑色素瘤相比，与黑色素瘤相关的痣的出现预示着更好的无复发生存率。尽管肢端雀斑样痣黑色素瘤（70.9%）是最常见的组织学亚型，但只有9.6%的肢端雀斑样痣黑色素瘤与痣有关。此外，在临床病理因素和生存率方面，与痣相关的肢端雀斑样痣黑色素瘤和新发肢端雀斑样痣黑色素瘤之间没有统计学上的显著差异。总之，与痣相关的黑色素瘤在肢端雀斑样痣黑色素瘤中并不常见。相关地，由于亚洲人所有黑色素瘤中有超过一半是肢端雀斑样痣黑色素瘤，亚洲人患与痣相关黑色素瘤的可能性低于白种人。
