Folberg R, McLean I W, Zimmerman L E
Hum Pathol. 1985 Feb;16(2):136-43. doi: 10.1016/s0046-8177(85)80062-9.
One hundred thirty-one cases of conjunctival melanoma in which biopsies had been performed were studied to determine potential factors that might affect outcome in patients with these lesions. Two groups of lesions were identified: those associated with primary acquired melanosis (melanoma with PAM, 98 cases, 74.8 per cent) and those without primary acquired melanosis (melanoma without PAM, 33 cases, 25.2 per cent). The overall mortality rate in the 131 cases was 26 per cent (34 of 131); the mortality rate due to melanoma with PAM was 25.5 per cent (25 of 98), and that due to melanoma without PAM was 27.3 per cent (9 of 33). If PAM was associated with the lesion, the presence of atypical melanocytes within the epithelium (pagetoid invasion) was a sensitive indicator of subsequent metastasis. Tumor thickness may also be useful for predicting subsequent metastases. None of the histologic parameters studied proved useful for predicting outcome in patients who had melanomas without PAM. The presence or absence of nevi had no effect on prognosis.
对131例已进行活检的结膜黑色素瘤病例进行了研究，以确定可能影响这些病变患者预后的潜在因素。确定了两组病变：与原发性获得性黑素沉着相关的病变（伴有PAM的黑色素瘤，98例，占74.8%）和无原发性获得性黑素沉着的病变（无PAM的黑色素瘤，33例，占25.2%）。131例患者的总死亡率为26%（131例中的34例）；伴有PAM的黑色素瘤死亡率为25.5%（98例中的25例），无PAM的黑色素瘤死亡率为27.3%（33例中的9例）。如果PAM与病变相关，上皮内非典型黑素细胞的存在（派杰样浸润）是随后转移的敏感指标。肿瘤厚度也可能有助于预测随后的转移。所研究的组织学参数均未被证明对预测无PAM的黑色素瘤患者的预后有用。痣的有无对预后没有影响。
