1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece.
Department of Social and Behavioral Sciences, Harvard TH School of Public Health, Boston, MA, USA.
Br J Dermatol. 2021 Jul;185(1):101-109. doi: 10.1111/bjd.19819. Epub 2021 Apr 1.
Whether melanoma in histological contiguity with a naevus [naevus-associated melanoma (NAM)] is distinctly different from melanoma arising de novo remains unclear.
To determine whether the characteristics of de novo melanoma differ from NAM and are not due to naevus obliteration in thicker tumours.
We conducted a multicentre retrospective study of de novo melanoma and NAM in seven referral centres in Europe, Australia and the USA between 2006 and 2015.
In a total of 9474 localized melanomas, de novo melanoma was associated with thicker tumours and body site differences compared with NAM. In the subset of T melanomas (n = 5307), similar body site differences were found in multivariate analysis by body site. When compared with NAM, de novo melanoma was more likely to affect older individuals (≥ 70 years) when located on the head/neck [odds ratio (OR) 4·65, 95% confidence interval (CI) 2·55-8·46], the trunk (OR 1·82, 95% CI 1·40-2·36) or the upper extremity (OR 1·69, 95% CI 1·14-2·50), was more likely to affect female patients when located on the lower extremities (OR 1·36, 95% CI 1·03-1·80), and was more likely to be of the nodular melanoma subtype (OR 2·23, 95% CI 1·14-4·35) when located on the trunk. De novo melanoma was less likely to have regression present compared with NAM.
Clinicopathological and body site differences between de novo melanoma and NAM support the divergent pathway model of development. These differences were also found in thin melanomas, suggesting that de novo melanomas are different from NAM and their differences are not due to the obliteration of naevus remnants in thicker tumours.
黑素瘤与痣在组织学上相邻[痣相关黑素瘤（NAM）]是否与新发黑素瘤明显不同尚不清楚。
确定新发黑素瘤的特征是否与 NAM 不同，且并非由于较厚肿瘤中痣的消退所致。
我们在 2006 年至 2015 年间，在欧洲、澳大利亚和美国的 7 个转诊中心进行了一项关于新发黑素瘤和 NAM 的多中心回顾性研究。
在总共 9474 例局限性黑素瘤中，与 NAM 相比，新发黑素瘤与较厚的肿瘤和身体部位差异相关。在 T 期黑素瘤亚组（n=5307）中，通过身体部位的多变量分析发现了类似的身体部位差异。与 NAM 相比，当位于头颈部[比值比（OR）4.65，95%置信区间（CI）2.55-8.46]、躯干（OR 1.82，95%CI 1.40-2.36）或上肢（OR 1.69，95%CI 1.14-2.50）时，位于下肢的患者年龄更大（≥70 岁）、为女性（OR 1.36，95%CI 1.03-1.80）的可能性更大，且位于躯干时更可能为结节性黑素瘤亚型（OR 2.23，95%CI 1.14-4.35）。与 NAM 相比，新发黑素瘤不太可能出现消退。
新发黑素瘤与 NAM 之间的临床病理和身体部位差异支持发展的不同途径模型。在薄型黑素瘤中也发现了这些差异，这表明新发黑素瘤与 NAM 不同，且其差异并非由于较厚肿瘤中痣残余物的消退所致。
