Kato T, Suetake T, Sugiyama Y, Tanita Y, Kumasaka K, Takematsu H, Tomita Y, Tagami H
Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan.
Clin Exp Dermatol. 1993 Mar;18(2):107-10. doi: 10.1111/j.1365-2230.1993.tb00988.x.
While the incidence of malignant melanoma is much lower in Japanese than in Caucasians, the commonest site of melanoma in Japanese has been reported to be the acral regions of the limbs. The survival rate for acral and nodular melanoma observed at the Department of Dermatology, Tohoku University Hospital in Sendai, Japan from 1969 to 1990 was reviewed. Among 150 melanoma patients 125 (83%) and 17 (11%) had primary cutaneous melanoma and mucous membrane melanomas, respectively. Frequent sites for cutaneous melanomas were the sole (31%) and subungual regions (15%). Comparison of the stages of plantar melanoma at diagnosis showed that the proportion of stages III and IV decreased after 1980 with a corresponding increase in those with a tumour thickness of less than 4 mm (stage II). Concurrently, the prognosis of plantar melanoma has improved; the 5-year survival rate in each of the three periods 1969-75, 1976-80 and 1981-85 was 21, 70 and 90%, respectively. This was also the case with subungual melanoma. Such improvements in the prognosis are thought to be mainly due to early detection through the growing public awareness of this life-threatening disease. By contrast cases of nodular melanoma increased sharply after 1980. Among these, the high proportion of patients in advanced stages (stages III and IV) remained static even after 1980, with a resultant low 5-year survival rate in the above mentioned periods of 33, 38 and 18%, respectively.
虽然日本恶性黑色素瘤的发病率远低于白种人，但据报道，日本人黑色素瘤最常见的部位是四肢的肢端区域。我们回顾了1969年至1990年期间在日本仙台东北大学医院皮肤科观察到的肢端和结节性黑色素瘤的生存率。在150例黑色素瘤患者中，125例（83%）患有原发性皮肤黑色素瘤，17例（11%）患有黏膜黑色素瘤。皮肤黑色素瘤的常见部位是足底（31%）和甲下区域（15%）。对诊断时足底黑色素瘤分期的比较显示，1980年后III期和IV期的比例下降，肿瘤厚度小于4mm（II期）的比例相应增加。同时，足底黑色素瘤的预后有所改善；1969 - 1975年、1976 - 1980年和1981 - 1985年这三个时期的5年生存率分别为21%、70%和90%。甲下黑色素瘤也是如此。预后的这种改善被认为主要是由于公众对这种危及生命疾病的认识提高，从而实现了早期检测。相比之下，结节性黑色素瘤的病例在1980年后急剧增加。其中，晚期（III期和IV期）患者的高比例即使在1980年后仍保持不变，导致上述时期的5年生存率较低，分别为33%、38%和18%。
