Marghoob A A, Slade J, Kopf A W, Salopek T G, Rigel D S, Bart R S
Ronald O.Perelman Department of Dermatology, New York University School of Medicine, New York, USA.
Br J Dermatol. 1996 Nov;135(5):704-11.
The classic atypical-mole syndrome (CAMS) and/or a history of malignant melanoma (MM) increases the risk for multiple melanomas. Case notes of 118 CAMS and 173 control patients, each with a history of MM, were reviewed for the occurrence of second primary MMs. The mean (+/-SD) age at diagnosis of the first MM was 38.8 +/- 12.8 and 48.9 +/- 14.7 years (P < 0.001) for CAMS cases and controls, respectively. Thirty-two of 118 CAMS and 18 of 173 controls developed second primary MMs, for a cumulative 10-year life-table risk of 35.5% and 17.0%, respectively (P < 0.0001). The mean number of months from the time of diagnosis of the first to the second MM was 33.9 +/- 41.8 and 58.6 +/- 57.3 months for the CAMS and controls, respectively (P = 0.08). In both cohorts the second MMs were significantly thinner, compared with the first MMs. The relative risk (RR) for developing second MMs for CAMS patients was 3.2. The RR for the CAMS cohort compared with a matched population from the United States Statistics, Epidemiology. End Results data base was 337, and for the controls, the RR was 84. All patients with MMs are at significant risk for developing multiple MMs: the risk is greater for patients with CAMS. Periodic total cutaneous examinations are indicated for life in an attempt to identify new MMs when they are thin.
经典非典型痣综合征（CAMS）和/或恶性黑色素瘤（MM）病史会增加患多发性黑色素瘤的风险。对118例CAMS患者和173例对照患者（均有MM病史）的病例记录进行回顾，以了解第二原发性MM的发生情况。CAMS病例组和对照组首次诊断MM时的平均（±标准差）年龄分别为38.8±12.8岁和48.9±14.7岁（P<0.001）。118例CAMS患者中有32例、173例对照中有18例发生了第二原发性MM，累积10年生命表风险分别为35.5%和17.0%（P<0.0001）。CAMS患者和对照组从首次诊断MM到第二次诊断MM的平均月数分别为33.9±41.8个月和58.6±57.3个月（P=0.08）。在两个队列中，与首次MM相比，第二次MM明显更薄。CAMS患者发生第二原发性MM的相对风险（RR）为3.2。与来自美国统计、流行病学。最终结果数据库的匹配人群相比，CAMS队列的RR为337，对照组的RR为84。所有MM患者都有发生多发性MM的显著风险：CAMS患者的风险更高。建议对所有患者进行终身定期全皮肤检查，以便在新的MM较薄时将其识别出来。
