Rieger E, Soyer H P, Garbe C, Büttner P, Kofler R, Weiss J, Stocker U, Krüger S, Roser M, Weckbecker J
Department of Dermatology, University Hospitals of Graz, Austria.
Int J Cancer. 1995 Aug 9;62(4):393-7. doi: 10.1002/ijc.2910620406.
A large number of benign melanocytic nevi is the major risk factor for malignant melanoma (MM). In a multicenter case-control study, the number of common (CN) and clinically atypical (AN) nevi were counted separately at individual sites in 278 melanoma patients and 278 age- and gender-matched non-melanoma controls. Relative risk (RR) adjusted for age and sex was calculated. In men as well as women, the number of CN on the legs was the best predictor of overall melanoma risk. In men, RR for developing MM when > or = 1 AN were present on the trunk was 4-fold (vs. none). In women, presence of AN on the arms increased RR 9.5-fold. For men and women combined, after adjusting for age and gender, the RR for developing MM on the trunk and on the legs was best predicted by counts of CN at the respective body region. However, high counts of CN on the arms were associated with high melanoma risk on the legs (somewhat lower on the trunk). For AN, no site-specificity of melanoma risk was found. Our data suggest that nevus counts of the legs are the best predictor of overall melanoma risk if total body nevus counts are not feasible. Although high counts of CN on the trunk and legs are associated with a higher risk of developing MM at the respective site than at another site, our data do not unequivocally support a direct site-specific melanoma risk.
大量良性黑素细胞痣是恶性黑色素瘤（MM）的主要危险因素。在一项多中心病例对照研究中，分别对278例黑色素瘤患者以及278例年龄和性别匹配的非黑色素瘤对照个体各部位的普通痣（CN）和临床非典型痣（AN）数量进行计数。计算调整年龄和性别的相对风险（RR）。在男性和女性中，腿部CN的数量是总体黑色素瘤风险的最佳预测指标。在男性中，躯干上存在≥1个AN时发生MM的RR为4倍（与无AN相比）。在女性中，手臂上存在AN使RR增加9.5倍。对于男性和女性合并而言，在调整年龄和性别后，躯干和腿部发生MM的RR最好通过相应身体部位的CN计数来预测。然而，手臂上CN数量多与腿部黑色素瘤风险高相关（躯干上稍低）。对于AN，未发现黑色素瘤风险的部位特异性。我们的数据表明，如果无法进行全身痣计数，腿部痣计数是总体黑色素瘤风险的最佳预测指标。虽然躯干和腿部CN数量多与在相应部位而非其他部位发生MM的风险较高相关，但我们的数据并未明确支持直接的部位特异性黑色素瘤风险。
