Bergenmar M, Ringborg U, Månsson Brahme E, Brandberg Y
Department of Oncology, Karolinska Hospital, Stockholm, Sweden.
Melanoma Res. 1998 Oct;8(5):403-11. doi: 10.1097/00008390-199810000-00004.
Tumour thickness is the most important prognostic factor in malignant melanoma. To reduce the melanoma-related mortality, factors related to the presentation of thick melanoma have to be identified. Three samples of melanoma patients (n=694) were studied for this purpose. Histogenetic type was the only factor which differentiated between 'thin' (< or = 0.8 mm) and 'thick' (> 2.0 mm) lesions. During a 10-year period only 3% of the nodular lesions were 'thin' at diagnosis. Differences in knowledge about melanoma or the location of the lesion (either 'easy' or 'difficult' for the patient to observe) did not explain differences in tumour thickness. The most common tumour site irrespective of histogenetic type and gender was 'back of the trunk'. 'Increase in diameter' and 'bleeding' were the symptoms most frequently reported by patients with 'thick' melanoma. 'Thick' lesions were diagnosed in older age groups and in men to a greater extent. Considering these results, melanoma prevention should also be targeted to older age groups and attention should be paid to symptoms such as 'increase in diameter' even in the absence of other characteristic symptoms of melanoma. An increased proportion of nodular melanoma diagnosed as 'thin' lesions can be interpreted as a step forward in secondary prevention.
肿瘤厚度是恶性黑色素瘤最重要的预后因素。为降低黑色素瘤相关死亡率，必须确定与厚黑色素瘤表现相关的因素。为此研究了三组黑色素瘤患者样本（n = 694）。组织发生类型是区分“薄”（≤0.8 mm）和“厚”（>2.0 mm）病变的唯一因素。在10年期间，仅3%的结节性病变在诊断时为“薄”型。对黑色素瘤的了解或病变位置（患者观察“容易”或“困难”）的差异并不能解释肿瘤厚度的差异。无论组织发生类型和性别如何，最常见的肿瘤部位是“躯干后部”。“直径增大”和“出血”是“厚”黑色素瘤患者最常报告的症状。“厚”病变在老年组和男性中诊断出的比例更高。考虑到这些结果，黑色素瘤预防也应针对老年组，即使在没有黑色素瘤其他特征性症状的情况下，也应关注“直径增大”等症状。诊断为“薄”病变的结节性黑色素瘤比例增加可被视为二级预防的一个进步。
