Huvos A G, Miké V, Donnellan M J, Seemayer T, Strong E W
Am J Pathol. 1973 Apr;71(1):33-48.
The division of cutaneous malignant melanomas into nodular melanoma, malignant melanoma arising in Hutchinson's melanotic freckle and superficial spreading melanoma has, in many studies, indicated its usefulness for assessing prognosis. The depth of dermal invasion was also found to be an important prognostic factor. The present retrospective study of 119 patients, seen at Memorial Sloan-Kettering Cancer Center from 1947 to 1964, with cutaneous malignant melanoma of the head and neck area examines the above three types of melanoma as well as the depth of dermal invasion. The clinical and pathologic features and course of the disease in these patients were studied by means of a comprehensive statistical analysis. There was significant correlation between the depth of invasion and type of malignant melanoma, with the nodular type being the most deeply penetrating and melanoma arising in Hutchinson's melanotic freckle the most superficial (P < .01). The ten-year actuarial survival rates for clinical stage I patients when grouped according to dermal level of penetration were level II, 86%, vs level V, 44% (P < .01); levels III and IV were 60% and 57%, respectively. Correlations of importance were noted between ulceration and depth of dermal penetration, cellular pigment production and clinical pigmentation, as well as size of the primary lesion and depth of dermal invasion. It is suggested that future large-scale prospective studies include these useful parameters.
在许多研究中，将皮肤恶性黑色素瘤分为结节性黑色素瘤、哈钦森黑色素雀斑样痣恶变型黑色素瘤和浅表扩散性黑色素瘤，已表明其在评估预后方面的有用性。真皮浸润深度也被发现是一个重要的预后因素。本回顾性研究对1947年至1964年在纪念斯隆-凯特琳癌症中心就诊的119例头颈部皮肤恶性黑色素瘤患者进行了研究，分析了上述三种类型的黑色素瘤以及真皮浸润深度。通过全面的统计分析研究了这些患者的临床和病理特征以及疾病进程。浸润深度与恶性黑色素瘤类型之间存在显著相关性，结节型浸润最深，哈钦森黑色素雀斑样痣恶变型黑色素瘤最表浅（P <.01）。根据真皮浸润水平分组的I期临床患者的十年精算生存率为：II级，86%，而V级为44%（P <.01）；III级和IV级分别为60%和57%。观察到溃疡与真皮浸润深度、细胞色素产生与临床色素沉着以及原发灶大小与真皮浸润深度之间存在重要相关性。建议未来的大规模前瞻性研究纳入这些有用的参数。
