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新冠疫情对黑色素瘤诊断和预后的影响

Impact of the COVID-19 Pandemic on the Diagnosis and Prognosis of Melanoma.

作者信息

Martinez-Lopez Antonio, Diaz-Calvillo Pablo, Cuenca-Barrales Carlos, Montero-Vilchez Trinidad, Sanchez-Diaz Manuel, Buendia-Eisman Agustin, Arias-Santiago Salvador

机构信息

Dermatology Unit, Virgen de las Nieves University Hospital, 18014 Granada, Spain.

TECe19-Investigational and Traslational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), 18012 Granada, Spain.

出版信息

J Clin Med. 2022 Jul 19;11(14):4181. doi: 10.3390/jcm11144181.

Abstract

Background: Early detection of melanoma is one of the main diagnostic goals of dermatologists worldwide, due to the increasing incidence of the disease in our environment. However, the irruption of the SARS-CoV-2 pandemic has posed a challenge to global healthcare, forcing systems to focus their resources on the fight against COVID-19. Methods: Retrospective cohort study. The exposed cohort were patients diagnosed with melanoma in the year after the general confinement in Spain (15 March 2020) and the unexposed cohort were patients with melanoma diagnosed in the previous year. Results: 130 patients were included. No differences were observed between demographic characteristics in both cohorts. The mean Breslow of melanoma before the onset of the pandemic was 1.08, increasing to 2.65 in the year after the onset of the pandemic (p < 0.001). On the other hand, the percentage of melanomas in situ decreased from 38.96% to 16.98% in the year after the declaration of the state of alarm in Spain. Conclusions: The SARS-CoV-2 outbreak has led to a reduction in the early diagnosis of melanoma, with an increase in invasive melanomas with poor prognosis histological factors. This could lead to an increase in melanoma-related mortality in the coming years in our environment.

摘要

背景

由于黑色素瘤在我们所处环境中的发病率不断上升,早期发现黑色素瘤是全球皮肤科医生的主要诊断目标之一。然而,SARS-CoV-2大流行的爆发给全球医疗保健带来了挑战,迫使各医疗系统将资源集中用于抗击COVID-19。方法:回顾性队列研究。暴露队列是在西班牙全面封锁后一年(2020年3月15日)被诊断为黑色素瘤的患者,未暴露队列是前一年被诊断为黑色素瘤的患者。结果:共纳入130例患者。两个队列的人口统计学特征未观察到差异。大流行开始前黑色素瘤的平均 Breslow厚度为1.08,大流行开始后一年增加到2.65(p < 0.001)。另一方面,在西班牙宣布进入警戒状态后的一年里,原位黑色素瘤的比例从38.96%降至16.98%。结论:SARS-CoV-2疫情导致黑色素瘤的早期诊断减少,侵袭性黑色素瘤增加,且预后不良的组织学因素增多。这可能导致未来几年我们所处环境中与黑色素瘤相关的死亡率上升。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7330/9321960/3c4d845806f5/jcm-11-04181-g001.jpg

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