Clark W H, Ainsworth A M, Bernardino E A, Yang C H, Mihm C M, Reed R J
Semin Oncol. 1975 Jun;2(2):83-103.
We have attempted to describe virtually all forms of malignant melanoma which affect man except those arising in the eye. The vast majority of malignant melanomas clearly fall into one of three kinds: (1) malignant melanoma of the superficial-spreading type, (2) malignant melanoma of the lentigo-maligna type, and (3) malignant melanoma of the nodular type. The developmental biology of a primary neoplasm is illustrated by discussing and illustrating the evolution of these three dominant forms of melanoma. Primary malignant melanoma of the superficial-spreading type and of the lentigo-maligna type develop through a characteristic biphasic growth pattern: an initial radial-growth phase, followed by a vertical-growth phase. The radial-growth phase of these melanomas is only rarely associated with the development of metastases, while the vertical-growth phase is commonly associated with subsequent metastatic disease. The phenomenon of the vertical-growth phase is apparently, therefore, a qualitative step in the development of a primary malignant melanoma. Malignant melanoma of the nodular type is an example of a primary tumor without a precursor developmental stage such as a radial-growth phase.
我们试图描述几乎所有影响人类的恶性黑色素瘤形式，但不包括眼部出现的那些。绝大多数恶性黑色素瘤显然可分为三种类型之一：（1）浅表扩散型恶性黑色素瘤，（2）恶性雀斑样痣型恶性黑色素瘤，以及（3）结节型恶性黑色素瘤。通过讨论和说明这三种主要类型黑色素瘤的演变，阐述了原发性肿瘤的发育生物学。浅表扩散型和恶性雀斑样痣型原发性恶性黑色素瘤通过一种特征性的双相生长模式发展：初始的径向生长阶段，随后是垂直生长阶段。这些黑色素瘤的径向生长阶段很少与转移的发生相关，而垂直生长阶段通常与随后的转移性疾病相关。因此，垂直生长阶段现象显然是原发性恶性黑色素瘤发展过程中的一个质的步骤。结节型恶性黑色素瘤是一种没有诸如径向生长阶段等前体发育阶段的原发性肿瘤的例子。
