Søndergaard K
Acta Pathol Microbiol Immunol Scand A. 1985 Mar;93(2):49-55.
In 2012 patients with primary malignant melanoma of the skin the primary lesion was reviewed microscopically and the depth of invasion was staged and the tumor thickness was measured. It was possible to improve the prognostic value of Clark's method by dividing Clark's level IV (reticular dermis) into 2 subgroups, level IV A and level IV B, corresponding to the upper half and the lower half of the reticular dermis, respectively. Level IV A lesions were correlated with a significantly better prognosis than level IV B lesions (p less than 0.0025). By combining depth of invasion and tumors thickness it was found that for each level of invasion (except for level II) the prognosis deteriorated significantly with increasing tumor thickness. Level II indicated an excellent prognosis regardless of tumor thickness. Conversely, it was found that for each subgroup of thickness (except for 0.76 - 1.50 mm) the prognosis was not influenced by level of invasion. In melanomas measuring 0.76 - 1.50 mm in thickness the survival rate was significantly deteriorated, the deeper the invasion (p = 0.0003). The prognostic value of measuring tumor thickness was superior to that of staging depth of invasion. In melanomas 0.76 - 1.50 mm thick, however, additional classification of depth of invasion improved the prognostic value significantly.
2012年，对皮肤原发性恶性黑色素瘤患者的原发性病灶进行了显微镜检查，对浸润深度进行了分期，并测量了肿瘤厚度。通过将克拉克IV级（网状真皮）分为2个亚组，即IV A级和IV B级，分别对应网状真皮的上半部分和下半部分，可以提高克拉克方法的预后价值。IV A级病灶的预后明显优于IV B级病灶（p<0.0025）。通过结合浸润深度和肿瘤厚度发现，对于每个浸润级别（II级除外），预后随着肿瘤厚度的增加而显著恶化。II级无论肿瘤厚度如何，预后均良好。相反，发现对于每个厚度亚组（0.76 - 1.50 mm除外），预后不受浸润级别的影响。在厚度为0.76 - 1.50 mm的黑色素瘤中，浸润越深，生存率显著恶化（p = 0.0003）。测量肿瘤厚度的预后价值优于浸润深度分期。然而，在厚度为0.76 - 1.50 mm的黑色素瘤中，额外的浸润深度分类显著提高了预后价值。
