痣相关性黑色素瘤的荟萃分析：患病率及实际意义。

A meta-analysis of nevus-associated melanoma: Prevalence and practical implications.

机构信息

Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy.

First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Am Acad Dermatol. 2017 Nov;77(5):938-945.e4. doi: 10.1016/j.jaad.2017.06.149. Epub 2017 Aug 29.

DOI:10.1016/j.jaad.2017.06.149

PMID:28864306

Abstract

The reported prevalence of nevus-associated melanoma varies substantially. We performed a systematic review and meta-analysis to determine the incidence and prevalence of this disease; we also performed subanalyses considering age, tumor thickness, and nevus-type classification. In 38 observational cohort and case-control studies, 29.1% of melanomas likely arose from a preexisting nevus and 70.9% de novo. Any given melanoma was 64% less likely to be nevus-associated than de novo (risk ratio 0.36, 95% confidence interval [CI] 0.29-0.44; P < .001; I = 99%); nevus-associated melanomas had a lower mean Breslow thickness than de novo melanomas (mean difference -0.39 mm; 95% CI -0.60 to -0.18; P = .0003; I = 66%). No significant differences were noted regarding the association of nevus-associated melanomas with nondysplastic nevi or dysplastic nevi (risk ratio 0.77, 95% CI 0.49-1.20; P = .24; I = 98%).

摘要

痣相关黑色素瘤的报道患病率差异很大。我们进行了系统评价和荟萃分析，以确定这种疾病的发病率和患病率；我们还进行了亚分析，考虑了年龄、肿瘤厚度和痣型分类。在 38 项观察性队列和病例对照研究中，29.1%的黑色素瘤可能源自先前存在的痣，70.9%为新发。任何给定的黑色素瘤发生痣相关的可能性比新发低 64%（风险比 0.36，95%置信区间 [CI] 0.29-0.44；P < 0.001；I = 99%）；痣相关黑色素瘤的平均 Breslow 厚度低于新发黑色素瘤（平均差异 -0.39 毫米；95%CI -0.60 至 -0.18；P = 0.0003；I = 66%）。关于痣相关黑色素瘤与非发育不良痣或发育不良痣的相关性，未观察到显著差异（风险比 0.77，95%CI 0.49-1.20；P = 0.24；I = 98%）。