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临床和皮肤镜特征的手术治疗的黑色素细胞痣:回顾性研究 1046 例。

Clinical and dermoscopic features of surgically treated melanocytic nevi: a retrospective study of 1046 cases.

机构信息

Department of Dermatology and Venerology, Peking University First Hospital, Beijing 100034, China.

Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing 100034, China.

出版信息

Chin Med J (Engl). 2019 Sep 5;132(17):2027-2032. doi: 10.1097/CM9.0000000000000416.

Abstract

BACKGROUND

Compared with Caucasians, unique demographic and clinical features have been reported in Chinese patients with malignant melanoma, but similar comparative studies of melanocytic nevi (MN) are lacking. This study examined the clinical and dermoscopic features of MN in surgically treated Chinese cases.

METHODS

Clinical data and dermoscopic findings from 1046 cases of MN were collected and analyzed. Cases were treated from January 1 to December 31, 2014 at the Department of Dermatology and Venerology, Peking University First Hospital. The association between nevi location and histologic subtypes was examined with Chi-squared test and univariate logistic regression. Chi-squared test was also used to analyze the proportion of globular patterns across different body sites, and proportion of parallel furrow patterns across different histologic subtypes.

RESULTS

The majority of the nevi were from female patients, irrespective of location. The range of age at the time of nevi onset was from 0 (birth) to 79 years. There were 381 (36.4%, 381/1046) congenital nevi; of these 81.6% (311/381) were present at birth. Nevi appeared before 30 years of age in 83.2% (870/1046) of the cases. Median values of length growth rate in congenital and acquired MN were 2.0 and 1.6, respectively. Median values of length growth rates in four age groups (0-9, 10-19, 20-29, and ≥30 years) of congenital nevi were 2.2, 2.0, 2.4, and 2.0, respectively. In acral nevi, which often need to be differentiated from acral lentiginous melanoma, 50.2% (109/217) were junctional (odds ratio [OR]; 95% confidence interval [CI]: 91.572 [52.210-160.959], P < 0.05). Acral location was also associated with a higher likelihood of compound nevi subtype (OR [95% CI]: 14.468 [8.981-23.306], P < 0.05). The globular (59.4%, 354/596) and pseudonetwork (48.8%, 291/596) dermoscopic patterns were often seen in the head and neck region. In areas other than head and neck and acral regions, the globular pattern was the commonest pattern (34.8%, 71/204) regardless of age. Parallel furrow pattern occurred in 46.0% (87/189) of acral MN, followed by fibrillar pattern (21.7%, 41/189).

CONCLUSION

Unique clinical and dermoscopic features exist in Chinese patients with MN compared with observations reported in other population.

摘要

背景

与高加索人相比,中国恶性黑色素瘤患者具有独特的人口统计学和临床特征,但类似的黑色素瘤(MN)的对比研究尚缺乏。本研究检测了在中国接受手术治疗的 MN 患者的临床和皮肤镜特征。

方法

收集并分析了 1046 例 MN 的临床数据和皮肤镜检查结果。病例来自北京大学第一医院皮肤科和性病科 2014 年 1 月 1 日至 12 月 31 日期间的治疗。使用卡方检验和单因素逻辑回归分析痣位置与组织学亚型之间的关系。还使用卡方检验分析不同部位的球形模式比例,以及不同组织学亚型的平行皱襞模式比例。

结果

大多数痣患者为女性,不论痣的位置如何。痣发病年龄范围为 0(出生)至 79 岁。381 例(36.4%,381/1046)为先天性痣;其中 81.6%(311/381)出生时即存在。83.2%(870/1046)的病例痣出现在 30 岁之前。先天性和获得性 MN 的长度增长率中位数分别为 2.0 和 1.6。0-9、10-19、20-29 和≥30 岁四个年龄组的先天性痣的长度增长率中位数分别为 2.2、2.0、2.4 和 2.0。在需要与肢端雀斑样黑色素瘤相鉴别的肢端痣中,50.2%(109/217)为交界性(比值比[OR];95%置信区间[CI]:91.572[52.210-160.959],P<0.05)。肢端位置也与复合痣亚型更常见相关(OR[95%CI]:14.468[8.981-23.306],P<0.05)。球形(59.4%,354/596)和伪网络(48.8%,291/596)皮肤镜模式常见于头颈部。在头颈部和肢端以外的区域,无论年龄大小,球形模式都是最常见的模式(34.8%,71/204)。平行皱襞模式见于 46.0%(87/189)的肢端 MN,其次是纤维状模式(21.7%,41/189)。

结论

与其他人群报道的观察结果相比,中国 MN 患者具有独特的临床和皮肤镜特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a581/6793791/a511fd690e73/cm9-132-2027-g002.jpg

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