患者识别的结节性黑素瘤早期临床预警征象：一项定性研究。

Patient-identified early clinical warning signs of nodular melanoma: a qualitative study.

机构信息

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 401 Park Drive, West Wing 4th floor, 403G, Boston, MA, 02215, USA.

Department of Psychology, University of Calgary, Calgary, Canada.

出版信息

BMC Cancer. 2021 Apr 7;21(1):371. doi: 10.1186/s12885-021-08072-4.

DOI:10.1186/s12885-021-08072-4

PMID:33827477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8028760/

Abstract

BACKGROUND

Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM.

METHODS

We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis.

RESULTS

We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, "dot-like" size, fast changes in shape and color observed over 2 weeks, elevation and texture or "puffiness" over 6-12 months, and the sensation that the mole "did not feel right". Early signs reported by both thin NM and thin SSM patients included round or oblong shape, "jagged" border, pink/red, brown/reddish or dark coloration, "elevated like a pimple" or "tiny bump", fast color darkening, diameter growth, and border irregularity, and mole feeling "really itchy".

CONCLUSIONS

We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.

摘要

背景

结节性（NM）和浅表扩散性黑色素瘤（SSM）表现出不同的疾病轨迹，NM 发展更为迅速，且早期检测机会较少，通常导致更差的结局。我们的研究通过与薄型（≤2mm）SSM 和厚型（>2mm）NM 进行比较，描述了 NM 患者可识别的早期特征。

方法

我们对 NM 和 SSM 患者进行了半结构化访谈，并使用主题分析对数据进行了分析。

结果

我们纳入了 34 例 NM 和 32 例 SSM 患者。NM 患者特有的 NM 早期征象包括白色、蓝色或黑色、“点状”大小、在 2 周内观察到的形状和颜色快速变化、在 6-12 个月内出现的隆起和质地或“肿胀”，以及痣“感觉不对劲”。NM 和 SSM 患者都报告的早期征象包括圆形或椭圆形、“锯齿状”边界、粉红色/红色、棕色/红棕色或暗褐色、“凸起像粉刺”或“小肿块”、颜色快速加深、直径增长和边界不规则，以及痣感觉“非常痒”。