Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
J Am Acad Dermatol. 2019 Apr;80(4):970-978. doi: 10.1016/j.jaad.2018.09.044. Epub 2019 Jan 31.
The presence of nevi portends an increased risk for melanoma.
We sought to examine the association between extremity nevus count and the risk of melanoma and keratinocyte cancers.
We evaluated prospective cohorts of 176,317 women (the Nurses' Health Study, 1986-2012 and the Nurses' Health Study 2, 1989-2013) and 32,383 men (Health Professionals Follow-up Study, 1986-2012). Information on nevus count (none, 1-5, 6-14, ≥15) on the extremity was collected at baseline.
There were 1704 incident cases of melanoma, 2296 incident cases of squamous cell carcinoma, and 30,457 incident cases of basal cell carcinoma, with a total of 4,655,043 person-years for melanoma and 4,267,708 person-years for keratinocyte cancers. The presence of an extremity nevus was associated with an increased risk of melanoma in all anatomic areas and increased risk of basal cell carcinoma (BCC). Individuals with ≥15 nevi had the highest risk of melanoma and BCC compared to those without any extremity nevi (melanoma hazard ratio 2.79 [95% confidence interval 2.04-3.83]; BCC HR 1.40 [95% confidence interval 1.32-1.49]). No significant association was observed for squamous cell carcinoma.
Limitations of our study included self-reported nevus count and detection bias.
Extremity nevus count is a helpful clinical marker in risk-stratifying individuals for BCC and melanoma on all body sites.
痣的存在预示着黑色素瘤风险增加。
我们旨在研究四肢痣计数与黑色素瘤和角质形成细胞癌风险之间的关联。
我们评估了 176317 名女性（护士健康研究，1986-2012 年和护士健康研究 2，1989-2013 年）和 32383 名男性（健康专业人员随访研究，1986-2012 年）的前瞻性队列。基线时收集四肢痣计数（无、1-5、6-14、≥15）的信息。
共有 1704 例黑色素瘤、2296 例鳞状细胞癌和 30457 例基底细胞癌病例，黑色素瘤和角质形成细胞癌的总随访时间分别为 4655043 人年和 4267708 人年。四肢痣的存在与所有解剖区域的黑色素瘤风险增加以及基底细胞癌（BCC）风险增加相关。与无任何四肢痣的人相比，≥15 颗痣的人黑色素瘤和 BCC 的风险最高（黑色素瘤危险比 2.79[95%置信区间 2.04-3.83]；BCC HR 1.40[95%置信区间 1.32-1.49]）。未观察到与鳞状细胞癌的显著关联。
我们研究的局限性包括自我报告的痣计数和检测偏倚。
四肢痣计数是一种有用的临床标志物，可用于对所有身体部位的 BCC 和黑色素瘤个体进行风险分层。
