3688 Department of Dermatology, Dalhousie University, Halifax, NS, Canada.
432234 Research Methods Unit, Nova Scotia Health Authority, Centre for Clinical Research, Halifax, NS, Canada.
J Cutan Med Surg. 2022 Sep-Oct;26(5):473-476. doi: 10.1177/12034754221108978. Epub 2022 Jun 28.
Melanoma is one of the most common cancers in Canada, with the highest incidence in Nova Scotia (NS).
To describe the demographics, lesion characteristics, and diagnostic accuracy of suspected melanomas excised at the largest center in NS.
The dermatopathology database was interrogated for cases of possible melanoma from 2015 through 2019. Age, gender, site of lesion, pathologic diagnosis, Breslow depth, and equivocal pathology were assessed.
984 lesions had a clinical diagnosis of possible melanoma, identifying 301 melanomas. Of these, 142 (47%) were melanoma in situ (MIS) which in females occurred mostly on the extremities, while in males the head predominated. For invasive melanoma (IM), the extremities remained predominant for women, while the back was most common in men. Lower extremity lesions were more likely to be invasive and female patients were more likely to present with them at a younger age compared to males. The pathology was challenging for 23.94% of MIS, and 16.18% of IM. A mean of 3.1 lesions were excised for every melanoma identified.
Early diagnosis of melanoma is challenging clinically and pathologically. Our melanoma detection rate was 31%, with an increasing trend in the proportion of MIS, and decreasing trend in the proportion of IM over the years. Almost 50% of melanomas were detected in early stages, supporting positive outcomes. Melanomas were more common on extremities in females and the back in males. Melanomas on the lower limbs were more likely to be invasive regardless of gender.
黑色素瘤是加拿大最常见的癌症之一，新斯科舍省（NS）的发病率最高。
描述 NS 最大中心切除的疑似黑色素瘤的人口统计学、病变特征和诊断准确性。
从 2015 年到 2019 年，对皮肤科病理学数据库中可能患有黑色素瘤的病例进行了查询。评估了年龄、性别、病变部位、病理诊断、Breslow 深度和不确定的病理。
984 处病变有疑似黑色素瘤的临床诊断，确定了 301 例黑色素瘤。其中，142 例（47%）为原位黑色素瘤（MIS），女性 MIS 主要发生在四肢，而男性则以头部为主。对于浸润性黑色素瘤（IM），女性的四肢仍然是主要部位，而男性背部最常见。下肢病变更可能是侵袭性的，与男性相比，女性患者更年轻就诊。MIS 的病理学为 23.94%，IM 为 16.18%。每识别出一个黑色素瘤，平均切除 3.1 个病变。
黑色素瘤的临床和病理早期诊断具有挑战性。我们的黑色素瘤检出率为 31%，MIS 的比例呈上升趋势，IM 的比例呈下降趋势。近 50%的黑色素瘤处于早期阶段，支持良好的预后。女性黑色素瘤更常见于四肢，男性黑色素瘤更常见于背部。无论性别如何，下肢黑色素瘤更有可能是侵袭性的。
