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恶性黑色素瘤与妊娠:十个问题

Malignant melanoma and pregnancy ten questions.

作者信息

Dillman R O, Vandermolen L A, Barth N M, Bransford K J

机构信息

Hoag Cancer Center, Hoag Memorial Hospital Presbyterian, Newport Beach, California, USA.

出版信息

West J Med. 1996 Feb;164(2):156-61.

Abstract

Eight patient case vignettes are presented to illustrate the possible relationship between melanoma and pregnancy. We pose 10 questions regarding the risk and prognosis and answer them based on information in the medical literature. Key conclusions are that there is no evidence that the risk for melanoma is influenced by pregnancy; there is no evidence that abortion in pregnant women diagnosed with melanoma is therapeutic for the mother or necessary to prevent melanoma in the fetus; although as a group, pregnant women diagnosed with melanoma may have a somewhat worse prognosis compared with nonpregnant controls, this difference disappears when patients are matched for factors including age, location and depth of primary, or stage of disease; and there is still a concern that pregnant women may present with more invasive or advanced disease due to hormonal or growth factor effects or delays in diagnosis because changes are attributed to pregnancy.

摘要

本文呈现了八个患者病例 vignettes,以说明黑色素瘤与妊娠之间可能存在的关系。我们提出了10个关于风险和预后的问题,并根据医学文献中的信息进行解答。主要结论如下:没有证据表明妊娠会影响黑色素瘤的发病风险;没有证据表明被诊断为黑色素瘤的孕妇进行流产对母亲有治疗作用或对预防胎儿患黑色素瘤是必要的;尽管总体而言,被诊断为黑色素瘤的孕妇与未怀孕的对照组相比,预后可能稍差,但当根据年龄、原发灶的位置和深度或疾病分期等因素对患者进行匹配时,这种差异就会消失;并且仍然存在一种担忧,即由于激素或生长因子的影响或诊断延迟(因为变化被归因于妊娠),孕妇可能会出现更具侵袭性或更晚期的疾病。

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本文引用的文献

1
The prognosis for malignant melanoma in the pregnant woman.孕妇恶性黑色素瘤的预后。
Cancer. 1951 Mar;4(2):324-34. doi: 10.1002/1097-0142(195103)4:2<324::aid-cncr2820040218>3.0.co;2-g.
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Melanoma with pregnancy. A report of 115 cases.
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Does pregnancy influence the prognosis of malignant melanoma?妊娠是否会影响恶性黑色素瘤的预后?
J Am Acad Dermatol. 1993 Oct;29(4):619-30. doi: 10.1016/0190-9622(93)70229-m.
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Melanoma and pregnancy. A review.黑色素瘤与妊娠。综述。
Acta Oncol. 1993;32(4):371-8. doi: 10.3109/02841869309093613.
8
Sex, pregnancy, hormones, and melanoma.性别、妊娠、激素与黑色素瘤。
BMJ. 1993 Jul 3;307(6895):2-3. doi: 10.1136/bmj.307.6895.2.
10
Cancer statistics, 1994.1994年癌症统计数据。
CA Cancer J Clin. 1994 Jan-Feb;44(1):7-26. doi: 10.3322/canjclin.44.1.7.

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