Carli P, Biggeri A, Giannotti B
Dermatology Clinic II, University of Florence, Italy.
J Am Acad Dermatol. 1995 May;32(5 Pt 1):734-9. doi: 10.1016/0190-9622(95)91451-x.
Most epidemiologic studies on risk factors for cutaneous melanoma have been performed in predominantly fair-skinned populations.
Our purpose was to assess by means of a case-control study the importance of common melanocytic nevi (CMN) and clinically atypical nevi (CAN) as risk factors for cutaneous melanoma in a Mediterranean population.
One hundred six patients with invasive cutaneous melanoma and 109 population control subjects were included in the study. All subjects were younger than 70 years of age and were residents of the Florence area.
The adjusted odds ratios obtained by exact conditional analysis, accounting for age, sex, place of birth, and residence, were 2.6 (95 confidence interval [CI], 1.0 to 6.7) for 10 to 30 CMN, and 22.3 (CI, 4.8 to 215) for more than 30 CMN (chi 2 for trend, 25.41; p < 0.001), 2.9 (CI, 1.2 to 7.5) for large nevi, and 8.4 (CI, 2.2 to 31.4) for CAN. Tendency to freckle resulted in a twofold increase in risk (odds ratio, 2.2) (CI, 1.0 to 5.2). The relative risk associated with a large number of CMN was statistically significant after adjustment for all other variables. When adjusted for the number of CMN, none of the other variables showed a statistically significant increased risk.
A large number of CMN represents the most important risk factor for cutaneous melanoma in the Italian population. The presence of large nevi and CAN did not result in an increased risk when the number of CMN was considered.
大多数关于皮肤黑色素瘤危险因素的流行病学研究主要在皮肤白皙的人群中进行。
我们旨在通过一项病例对照研究评估普通黑素细胞痣（CMN）和临床非典型痣（CAN）作为地中海人群皮肤黑色素瘤危险因素的重要性。
该研究纳入了106例侵袭性皮肤黑色素瘤患者和109名人群对照。所有受试者年龄均小于70岁，均为佛罗伦萨地区居民。
通过精确条件分析得出的校正比值比，在考虑年龄、性别、出生地和居住地后，10至30个CMN的比值比为2.6（95%置信区间[CI]，1.0至6.7），超过30个CMN的比值比为22.3（CI，4.8至215）（趋势检验卡方值为25.41；p<0.001），大痣的比值比为2.9（CI，1.2至7.5），CAN的比值比为8.4（CI，2.2至31.4）。雀斑倾向使风险增加两倍（比值比，2.2）（CI，1.0至5.2）。在对所有其他变量进行调整后，与大量CMN相关的相对风险具有统计学意义。当对CMN数量进行调整后，其他变量均未显示出统计学上显著增加的风险。
大量CMN是意大利人群皮肤黑色素瘤最重要的危险因素。当考虑CMN数量时，大痣和CAN的存在并未导致风险增加。
