Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital and Institute, Beijing, China; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
J Am Acad Dermatol. 2019 May;80(5):1284-1291. doi: 10.1016/j.jaad.2018.12.058. Epub 2019 Jan 11.
It was unclear whether an increased number of common nevi (moles) predicts melanoma death.
We prospectively examined the association between number of common nevi and risk of melanoma death.
Our study used data from the Nurses' Health Study (n = 77,288 women) and Health Professionals Follow-up Study (n = 32,455 men). In 1986, participants were asked about the number of moles they had with a ≥3-mm diameter on the upper extremity, and we stratified their answers into 3 categories (none, 1-2, or ≥3) on the basis of data distribution.
During follow-up (1986-2012), 2452 melanoma cases were pathologically confirmed; among these, we identified 196 deaths due to melanoma. Increased number of nevi was associated with melanoma death; the hazard ratio (HR) for ≥3 nevi compared with no nevi was 2.49 (95% confidence interval [CI] 1.50-4.12) for women and 3.97 (95% CI 2.54-6.22) for men. Among melanoma cases, increased number of nevi was associated with melanoma death in men (≥3 nevi, HR 1.89, 95% CI 1.17-3.05) but not in women. Similarly, the number of nevi was positively associated with Breslow thickness in men only (P = .01).
This is an epidemiologic study without examination into mechanisms.
Increased number of cutaneous nevi was significantly associated with melanoma death. High nevus count might serve as an independent prognostic factor to predict the risk of melanoma death particularly among male melanoma patients.
痣（痣细胞痣）数量的增加是否预示黑色素瘤死亡尚不清楚。
我们前瞻性地研究了痣数量与黑色素瘤死亡风险之间的关系。
我们的研究使用了来自护士健康研究（n=77288 名女性）和健康专业人员随访研究（n=32455 名男性）的数据。1986 年，参与者被问及他们在上肢有≥3mm 直径的痣的数量，并根据数据分布将他们的答案分为 3 类（无、1-2 个或≥3 个）。
在随访期间（1986-2012 年），有 2452 例黑色素瘤病例经病理证实；其中，我们确定了 196 例因黑色素瘤死亡的病例。痣数量的增加与黑色素瘤死亡相关；与无痣相比，痣数量≥3 的女性发生黑色素瘤死亡的风险比（HR）为 2.49（95%置信区间[CI]为 1.50-4.12），男性为 3.97（95%CI 为 2.54-6.22）。在黑色素瘤病例中，痣数量的增加与男性黑色素瘤死亡相关（痣数量≥3，HR 为 1.89，95%CI 为 1.17-3.05），但在女性中无相关性。同样，只有男性的痣数量与 Breslow 厚度呈正相关（P=0.01）。
这是一项没有机制研究的流行病学研究。
痣的数量与黑色素瘤死亡显著相关。高痣计数可能是预测黑色素瘤死亡风险的独立预后因素，尤其是在男性黑色素瘤患者中。
