Breslow A, Macht S D
Plast Reconstr Surg. 1978 Mar;61(3):342-6. doi: 10.1097/00006534-197803000-00006.
A review of the literature on melanoma indicates that age, sex, size, ulceration, presence of satellites, absence of melanin, and whether or not the tumor is markedly raised above the surface of the surrounding skin are all useful criteria in evaluating the prognosis in Stage I cutaneous melanoma. Histological factors include the tumor type, the mitotic rate, and the maximum thickness of the tumor. The last is accurate for prognosis--objective, reproducible, and directly proportional to the mortality rate. Tumors less than 0.76 mm thick rarely, if ever, metastasize--and it appears that the size of the resection margin can safely be reduced for such thin tumors. The level of invasion (Clark) is less accurate in predicting the mortality.
一项关于黑色素瘤的文献综述表明，年龄、性别、大小、溃疡、卫星灶的存在、黑色素的缺失以及肿瘤是否明显高于周围皮肤表面，都是评估I期皮肤黑色素瘤预后的有用标准。组织学因素包括肿瘤类型、有丝分裂率和肿瘤的最大厚度。最后一项对于预后评估是准确的——客观、可重复，且与死亡率成正比。厚度小于0.76毫米的肿瘤极少发生转移——对于如此薄的肿瘤，似乎可以安全地缩小切除边缘的尺寸。浸润水平（克拉克分级）在预测死亡率方面不太准确。
