Abadir M C, Marghoob A A, Slade J, Salopek T G, Yadav S, Kopf A W
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, NY 10016, USA.
J Am Acad Dermatol. 1995 Jul;33(1):31-6. doi: 10.1016/0190-9622(95)90006-3.
It is not known why melanocytic nevi (MN) become dysmorphic (atypical) in patients with the atypical mole syndrome (AMS). A complex origin for acquired MN has been postulated. Genetic predisposition, solar radiation, and/or the formation of a sun-induced circulating mitogenic factor may contribute to the formation of MN.
This study was undertaken to help elucidate the pathogenesis of atypical MN in patients with AMS.
The number of common and atypical MN was determined for a defined sun-protected area on the buttocks in 150 patients with AMS (cases) and 150 control subjects without AMS. Patients and control subjects were matched for age and sex and were classified into risk groups for the development of malignant melanoma according to the Rigel classification.
MN on the buttocks were found in 23% of patients with AMS and 9% of control subjects (p < 0.003). In patients versus control subjects the mean number (1.3 vs 1.2, respectively) and mean diameter (5.7 vs 5.9 mm, respectively) of MN on the buttocks did not differ significantly. The MN in both patients and control subjects were not atypical clinically. The odds ratio for having AMS if MN were present on the buttocks was calculated to be 1.56 (95% confidence interval, 1.25 to 1.95).
Although the patients were 2.6 times more likely to have MN on their buttocks than the control subjects, clinically the MN did not differ significantly in number or appearance from those found on the buttocks of control subjects. It is hypothesized that the formation of some atypical MN requires direct solar radiation for their phenotypic expression.
目前尚不清楚在非典型痣综合征（AMS）患者中黑素细胞痣（MN）为何会变成发育异常（非典型）。后天性MN的起源较为复杂。遗传易感性、太阳辐射和/或太阳诱导的循环促有丝分裂因子的形成可能与MN的形成有关。
本研究旨在帮助阐明AMS患者中非典型MN的发病机制。
确定了150例AMS患者（病例组）和150例无AMS的对照者臀部特定防晒区域内普通MN和非典型MN的数量。患者和对照者按年龄和性别匹配，并根据里格尔分类法分为发生恶性黑色素瘤的风险组。
23%的AMS患者和9%的对照者臀部有MN（p<0.003）。患者与对照者相比，臀部MN的平均数量（分别为1.3和1.2）和平均直径（分别为5.7和5.9mm）无显著差异。患者和对照者的MN在临床上均无异常。计算得出臀部有MN时患AMS的优势比为1.56（95%置信区间为1.25至1.95）。
虽然患者臀部出现MN的可能性是对照者的2.6倍，但临床上患者臀部MN的数量和外观与对照者臀部的MN并无显著差异。据推测，一些非典型MN的形成需要直接太阳辐射来实现其表型表达。
