Marghoob N G, Liopyris K, Navarrete-Dechent C, Dusza S W, Balais G, Megaris A, Papageorgiou C, Apalla Z, Lallas A
OMSIII, New York Institute of Technology College of Osteopathic Medicine, New York, NY, USA.
Department of Dermatology, Mount Sinai, New York, NY, USA.
J Eur Acad Dermatol Venereol. 2020 Oct;34(10):2303-2307. doi: 10.1111/jdv.16367. Epub 2020 Apr 27.
Individuals with a high total naevus count (TNC) are at a higher risk to develop melanoma, and screening efforts have been largely focused on this group. However, some studies suggest that melanomas of patients with many nevi are thinner than those of patients with few nevi. Additionally, nodular melanoma has been associated with individuals with a low naevus count.
To investigate the association between TNC and melanoma Breslow thickness.
A two-centre retrospective study from 1 January 2016 to 1 January 2018. This included three hundred and twenty-six consecutive melanoma patients from two tertiary melanoma centres. The mean age at presentation was 58.3 years (SD = 15.9), and the majority (54.9%, N = 179) were men. Incidence of new in situ and invasive melanomas and correlation with TNC were measured.
The mean total naevus count for patients presenting with in situ melanoma was 57.2 (range 4-178), while for patients presenting with invasive disease was 31.5 (P = 0.01). In situ disease was associated with a higher TNC across all ages. For invasive melanoma, a positive association between age and Breslow thickness was observed, while TNC was inversely associated with Breslow thickness. Each additional naevus accounted for a 4% decreased likelihood that the subject had invasive disease.
Patients with a higher naevus count had thinner melanomas and more melanomas in situ, independent of age and sex.
总痣数（TNC）高的个体患黑色素瘤的风险更高，筛查工作主要集中在这一群体。然而，一些研究表明，痣多的患者的黑色素瘤比痣少的患者的黑色素瘤更薄。此外，结节性黑色素瘤与痣数少的个体有关。
研究总痣数与黑色素瘤Breslow厚度之间的关联。
一项2016年1月1日至2018年1月1日的两中心回顾性研究。该研究纳入了来自两个三级黑色素瘤中心的326例连续的黑色素瘤患者。就诊时的平均年龄为58.3岁（标准差=15.9），大多数（54.9%，N=179）为男性。测量了新的原位和侵袭性黑色素瘤的发病率及其与总痣数的相关性。
原位黑色素瘤患者的平均总痣数为57.2（范围4-178），而侵袭性疾病患者的平均总痣数为31.5（P=0.01）。在所有年龄段，原位疾病都与较高的总痣数相关。对于侵袭性黑色素瘤，观察到年龄与Breslow厚度呈正相关，而总痣数与Breslow厚度呈负相关。每增加一个痣，受试者患侵袭性疾病的可能性就降低4%。
痣数较多的患者黑色素瘤更薄，原位黑色素瘤更多，与年龄和性别无关。
