Pjanova Dace, Ruklisa Dace, Kregere Elza, Azarjana Kristine, Ozola Aija, Cema Ingrida
Cancer Cell Biology and Melanoma Research Group, Latvian Biomedical Research and Study Centre, Riga LV-1067, Latvia.
Newnham College, University of Cambridge, Cambridge CB3 9DF, UK.
Oncol Lett. 2020 Oct;20(4):117. doi: 10.3892/ol.2020.11978. Epub 2020 Aug 12.
Cutaneous melanoma (CM) is the most aggressive form of skin cancer, exhibits an increasing incidence worldwide and has a high potential to develop metastasis. The current study aimed to identify a set of parameters that may aid in predicting the probability and timing of the onset of CM metastasis. A retrospective analysis was performed using the archive data of 2,026 patients with CM that were treated at the Riga East University Hospital Latvian Oncology Centre, which is the largest oncological hospital in the country, between 1998 and 2015. A case-control study design was employed, where patients with metastasis (n=278) were used as the cases and patients without metastasis were used as the controls. The present study examined the associations between metastasis and potential risk factors and constructed multivariate models of features that predicted metastasis using stepwise regression. Time until metastasis was analyzed using negative binomial regression models. The results of the present study indicated an increase in the number of melanomas that developed metastases during 1998-2015. Tumor Breslow thickness was demonstrated to be significantly larger in patients with metastasis compared with those without (P=0.012). The presence of ulceration significantly increased the risk of metastases [odds ratio (OR), 1.66; 95% CI, 1.07-2.59; P=0.033]. The absence of pigment in melanoma tissues was indicated to lead to a greater likelihood of metastasis (OR, 2.14; 95% CI, 1.10-4.19; P=0.035). Shorter times from diagnosis until the onset of metastases were observed in older patients (incident rate ratio (IRR), 6.85; 95% CI, 2.43-19.30; P=2.78×10), and a borderline significant association was observed in those with ulcerated tumors (IRR, 1.33; 95% CI, 0.98-1.80; P=0.064). Therefore, the main features associated with the development of melanoma metastasis in Latvia were indicated to be tumor ulceration, absence of pigment and Breslow thickness.
皮肤黑色素瘤(CM)是最具侵袭性的皮肤癌形式,在全球范围内发病率呈上升趋势,且具有很高的发生转移的可能性。当前研究旨在确定一组参数,以帮助预测CM转移发生的概率和时间。利用1998年至2015年期间在拉脱维亚里加东部大学医院拉脱维亚肿瘤中心(该国最大的肿瘤医院)接受治疗的2026例CM患者的存档数据进行了回顾性分析。采用病例对照研究设计,将发生转移的患者(n = 278)作为病例,未发生转移的患者作为对照。本研究检查了转移与潜在风险因素之间的关联,并使用逐步回归构建了预测转移的特征多变量模型。使用负二项回归模型分析转移发生前的时间。本研究结果表明,1998年至2015年期间发生转移的黑色素瘤数量有所增加。与未发生转移的患者相比,发生转移的患者肿瘤Breslow厚度明显更大(P = 0.012)。溃疡的存在显著增加了转移风险[比值比(OR),1.66;95%置信区间,1.07 - 2.59;P = 0.033]。黑色素瘤组织中无色素被表明会导致转移的可能性更大(OR,2.14;95%置信区间,1.10 - 4.19;P = 0.035)。在老年患者中观察到从诊断到转移发生的时间较短(发病率比(IRR),6.85;95%置信区间,2.43 - 19.30;P = 2.78×10),在患有溃疡肿瘤的患者中观察到边缘显著关联(IRR,1.33;95%置信区间,0.98 - 1.80;P = 0.064)。因此,在拉脱维亚,与黑色素瘤转移发生相关的主要特征被表明是肿瘤溃疡、无色素和Breslow厚度。