Cooper P H, Wanebo H J, Hagar R W
Arch Dermatol. 1985 Sep;121(9):1127-31.
Forty-eight malignant melanomas of the extremities, 1 mm or less in maximal thickness, were studied to better define microscopic criteria of regression in thin melanomas. Eleven tumors (23%) exhibited definite regression in the form of one or more segmental areas (defects) where the invasive component was replaced by mononuclear cell infiltrate and fibrosis. Thirteen other tumors (27%) had diffuse, nonsegmental changes classified as probable regression. Nineteen lesions (40%) lacked regression, although 14 of these contained focal evidence of host response. Five melanomas (17% of lesions less than 0.75 mm thick) were equivocal for regression. There were no recurrences or metastases. The histologic diagnosis of regression in thin melanomas requires subjective judgments, but segmental defects represent a potentially reproducible criterion. Their width can be measured, and the proportion of the melanoma that has undergone regression can be estimated. The preponderance of data from the literature, supported by this study, indicates that regression has no prognostic importance in the vast majority of thin melanomas. There are observations, however, to suggest that in rare cases, regression may negate the prognostic value of microstaging of a thin melanoma. To date, the type and extent of such regressive changes have not been adequately defined.
对48例最大厚度为1mm或更薄的肢体恶性黑色素瘤进行了研究，以更好地确定薄黑色素瘤消退的微观标准。11例肿瘤（23%）表现出明确的消退，表现为一个或多个节段性区域（缺损），其中浸润成分被单核细胞浸润和纤维化所取代。另外13例肿瘤（27%）有弥漫性、非节段性改变，归类为可能消退。19个病变（40%）没有消退，尽管其中14个有宿主反应的局灶性证据。5例黑色素瘤（厚度小于0.75mm病变的17%）消退情况不明确。没有复发或转移。薄黑色素瘤消退的组织学诊断需要主观判断，但节段性缺损是一个潜在可重复的标准。可以测量其宽度，并估计发生消退的黑色素瘤的比例。本研究支持的文献中的大量数据表明，在绝大多数薄黑色素瘤中，消退没有预后意义。然而，有观察结果表明，在罕见情况下，消退可能会否定薄黑色素瘤微分期的预后价值。迄今为止，这种退行性变化的类型和程度尚未得到充分界定。
