Bernardino V B, Naidoff M A, Clark W H
Am J Ophthalmol. 1976 Sep;82(3):383-94. doi: 10.1016/0002-9394(76)90487-6.
A retrospective study of 23 conjunctival melanomas using the Clark classification revealed that the three most common forms of melanoma described in the skin--lentigo maligna melanoma (Hutchinson's freckle with melanoma), superficial spreading melanoma, and nodular melanoma--can be recognized in the conjunctiva. As in the skin, lentigo maligna melanoma appears to be associated with a good prognosis compared to the prognosis associated with superficial spreading melanoma. These two forms of melanoma are both associated with an intraepithelial stage and had previously been grouped under one designate, cancerous melanosis. They can be distinguished histologically although definite clinical differentiation will be determined in the future. Some melanomas with an intraepithelial stage, however, cannot be definitely classified. Relating all conjunctival cancerous melanoses to Hutchinson's melanotic freckle is no longer justified.
一项对23例结膜黑色素瘤采用克拉克分类法的回顾性研究显示，皮肤中描述的三种最常见的黑色素瘤类型——恶性雀斑样黑色素瘤（伴有黑色素瘤的哈钦森雀斑）、浅表扩散性黑色素瘤和结节性黑色素瘤——在结膜中也可被识别。与皮肤情况一样，与浅表扩散性黑色素瘤的预后相比，恶性雀斑样黑色素瘤似乎与较好的预后相关。这两种黑色素瘤类型均与上皮内阶段相关，以前曾被归为一类，即癌性黑变病。尽管未来将确定明确的临床鉴别方法，但它们在组织学上可被区分。然而，一些处于上皮内阶段的黑色素瘤无法明确分类。将所有结膜癌性黑变病都与哈钦森黑色素雀斑联系起来已不再合理。
