Larsen T E, Grude T H
Acta Pathol Microbiol Scand A. 1978 Sep;86A(5):437-50. doi: 10.1111/j.1699-0463.1978.tb02068.x.
A selected series of 669 primary malignant melanomas of the skin, stage I, has been classified according to Clark's system into lentigo maligna melanoma (86), superficial spreading malignant melanoma (259), nodular malignant melanoma (194) and unclassifiable malignant melanoma (130). It was often difficult to distinguish between lentigo maligna melanoma and superficial spreading malignant melanoma, and sometimes also between this last type and nodular melanoma. There seem to be borderline cases between the respective types. The 10-year specific cumulative survival rate (approximately the cure rate) was 98.3% for the lentigo maligna melanomas, 78.6% for nodular malignant melanomas and 76.7% for the unclassifiable group of melanomas. The 5-year observed prognosis ofthe 3 main types is satisfactory compared with other investigations. As the prognosis of the 3 types of cutaneous malignant melanoma differs considerably the use of this classification is recommended. The number of unclassifiable cases is likely to be reduced in the routine work when several sections of each tumour are studied.
一组669例I期原发性皮肤恶性黑色素瘤，已根据克拉克系统分为恶性雀斑样痣黑色素瘤（86例）、浅表扩散性恶性黑色素瘤（259例）、结节性恶性黑色素瘤（194例）和无法分类的恶性黑色素瘤（130例）。区分恶性雀斑样痣黑色素瘤和浅表扩散性恶性黑色素瘤常常很困难，有时区分最后这种类型与结节性黑色素瘤也有困难。各类型之间似乎存在交界病例。恶性雀斑样痣黑色素瘤的10年特异性累积生存率（大致为治愈率）为98.3%，结节性恶性黑色素瘤为78.6%，无法分类的黑色素瘤组为76.7%。与其他研究相比，3种主要类型的5年观察预后令人满意。由于3种皮肤恶性黑色素瘤的预后差异很大，建议采用这种分类方法。当对每个肿瘤的多个切片进行研究时，常规工作中无法分类的病例数量可能会减少。
