Larsen T E, Grude T H
Acta Pathol Microbiol Scand A. 1979 Mar;87A(2):131-8.
A selected series of 669 primary cutaneous malignant melanomas, stage I, was studied. The series includes 86 lentigo maligna melanomas, 259 superficial spreading malignant melanomas, 194 nodular malignant melanomas and 130 unclassifiable malignant melanomas. The cross-sectional profile, level of invasion, ulceration and vascular invasion were graded. The relation of these features to each other and to tumour type was studied by X2 tests. The prognostic value was also studied. The most common finding was a slightly elevated surface, level III of invasion, no ulceration and no vascular invasion. Most of these tumours were superficial spreading malignant melanomas. A good prognosis was associated with a flat cross-sectional profile, level II of invasion, no ulceration and no vascular invasion. A poor prognosis was associated with marked protrusion of the surface, level IV--V of invasion, ulceration and vascular invasion. Lentigo maligna melanomas tended to be more benign while nodular malignant melanomas tended to be more malignant than the average. A superficial spreading malignant melanoma could vary in either direction. The prognostic value of level of invasion and ulceration was found to be greater than that of tumour type. The prognostic importance of invasion no further than level III is stressed. Level of invasion ought to be reported to the clinician as well as the tumour type.
对一组选定的669例I期原发性皮肤恶性黑色素瘤进行了研究。该组包括86例恶性雀斑样痣黑色素瘤、259例浅表扩散性恶性黑色素瘤、194例结节性恶性黑色素瘤和130例无法分类的恶性黑色素瘤。对其横断面轮廓、浸润深度、溃疡和血管浸润进行了分级。通过卡方检验研究了这些特征之间以及与肿瘤类型的关系。还研究了其预后价值。最常见的表现是表面轻度隆起、浸润深度为III级、无溃疡和无血管浸润。这些肿瘤大多为浅表扩散性恶性黑色素瘤。预后良好与扁平的横断面轮廓、浸润深度为II级、无溃疡和无血管浸润相关。预后不良与表面明显突出、浸润深度为IV - V级、溃疡和血管浸润相关。恶性雀斑样痣黑色素瘤往往比平均情况更具良性，而结节性恶性黑色素瘤往往比平均情况更具恶性。浅表扩散性恶性黑色素瘤可能向任何一个方向变化。发现浸润深度和溃疡的预后价值大于肿瘤类型。强调浸润不超过III级的预后重要性。浸润深度以及肿瘤类型都应报告给临床医生。
