黑色素瘤高发家族儿童中的黑素细胞痣、发育异常痣和恶性黑色素瘤。

Melanocytic nevi, dysplastic nevi, and malignant melanoma in children from melanoma-prone families.

作者信息

Novakovic B, Clark W H, Fears T R, Fraser M C, Tucker M A

机构信息

Genetic Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892, USA.

出版信息

J Am Acad Dermatol. 1995 Oct;33(4):631-6. doi: 10.1016/0190-9622(95)91284-3.

DOI:10.1016/0190-9622(95)91284-3

PMID:7673498

Abstract

BACKGROUND

Melanocytic nevi, particularly dysplastic nevi (DN), are important markers of increased risk of malignant melanoma in adults, but little is known about their prevalence and relation to melanoma in children.

OBJECTIVE

Our purpose was to define the prevalence of DN, number of nevi, and their relation to the risk of melanoma in children younger than 20 years of age from melanoma-prone families.

METHODS

One hundred twenty-five persons younger than 20 years of age, from 23 melanoma-prone families, underwent clinical evaluation with nevus counts, photography, and biopsy of suspected melanocytic lesions and were observed for development of DN and melanoma.

RESULTS

In melanoma-prone families, 37% of children had DN. The patients were divided into four categories: those with melanoma, DN (without melanoma), indeterminant (largely because of age at examination), and unaffected. The risk of melanoma was assessed by nevus number and presence of DN. High nevus number was strongly correlated with the presence of DN. The risk of the development of melanoma in children from melanoma-prone families appeared most related to the presence of DN (relative risk, 45; 95% confidence intervals, 2.6-786.4) and started at an early age. Of note, all children in whom melanoma developed had DN.

CONCLUSION

Family history of melanoma and the presence of DN defines children with a high risk for melanoma developing at an early age.

摘要

背景

黑素细胞痣，尤其是发育异常痣（DN），是成人恶性黑色素瘤风险增加的重要标志物，但对于其在儿童中的患病率以及与黑色素瘤的关系知之甚少。

目的

我们的目的是确定来自黑素瘤易感家族的20岁以下儿童中DN的患病率、痣的数量及其与黑色素瘤风险的关系。

方法

来自23个黑素瘤易感家族的125名20岁以下人员接受了临床评估，包括痣计数、拍照以及对疑似黑素细胞病变进行活检，并观察DN和黑色素瘤的发生情况。

结果

在黑素瘤易感家族中，37%的儿童有DN。患者被分为四类：患有黑色素瘤的、有DN（无黑色素瘤）的、不确定的（主要由于检查时的年龄）和未受影响的。通过痣的数量和DN的存在来评估黑色素瘤的风险。高痣数量与DN的存在密切相关。来自黑素瘤易感家族的儿童发生黑色素瘤的风险似乎与DN的存在最为相关（相对风险，45；95%置信区间，2.6 - 786.4），且始于幼年。值得注意的是，所有发生黑色素瘤的儿童都有DN。