Giles G, Staples M, McCredie M, Coates M
Victorian Cancer Registry, Cancer Epidemiology Centre, Anti-Cancer Council of Victoria, Carlton South, Australia.
Melanoma Res. 1995 Dec;5(6):433-8.
All primary invasive cutaneous malignant melanomas (CMM) diagnosed in Victoria and New South Wales from 1985 to 1989 were obtained from the population-based cancer registries. Altogether 14,590 people with first CMMs were followed for at least 2 years, during which time 496 multiple primary CMMs were identified. Of the study population, 3.4% developed a second primary CMM and 0.3% developed three or more. It was estimated that 4.5% of people would develop a second CMM within 5 years of the first and that the risk was higher in males, particularly in men aged over 70 years. With regard to metachronous primaries, only age and thickness of the first primary were significant predictors of the thickness of the second: older people tended to have thicker CMMs and second CMMs were generally thinner than the first. Body site concordance was higher than expected by chance, particularly for synchronous diagnoses. The high degree of site concordance of metachronous primaries lent support to the hypothesis that skin adjacent to the first CMM might have undergone a 'field effect', rendering it at increased susceptibility to malignancy.
1985年至1989年在维多利亚州和新南威尔士州诊断出的所有原发性侵袭性皮肤恶性黑色素瘤（CMM）均来自基于人群的癌症登记处。共有14590例首次患CMM的患者被随访至少2年，在此期间，共识别出496例多发性原发性CMM。在研究人群中，3.4%的人发生了第二个原发性CMM，0.3%的人发生了三个或更多。据估计，4.5%的人在首次发病后的5年内会发生第二个CMM，男性的风险更高，尤其是70岁以上的男性。关于异时性原发性肿瘤，只有首次原发性肿瘤的年龄和厚度是第二个原发性肿瘤厚度的显著预测因素：年龄较大的人往往有较厚的CMM，第二个CMM通常比第一个薄。身体部位一致性高于偶然预期，尤其是同步诊断时。异时性原发性肿瘤的高度部位一致性支持了这样一种假设，即与第一个CMM相邻的皮肤可能经历了“场效应”，使其对恶性肿瘤的易感性增加。
