A retrospective cohort study of Southeast Asian patients with large congenital melanocytic nevi and the risk of melanoma development
A retrospective cohort study of Southeast Asian patients with large congenital melanocytic nevi and the risk of melanoma development
复制标题
DOI：
10.1016/j.jaad.2006.02.063
复制
发表时间：
2006-05-01
影响因子：
13.8
通讯作者：
Giam, YC
中科院分区：
文献类型：
--
作者：
Chan, YC;Giam, YC
背景：据估计，患有巨大先天性黑色素细胞痣(LCMN)的高加索人患黑色素瘤的终生风险在4.5%至10%之间。亚裔人群中LCMN与黑色素瘤发病风险的队列研究尚未见报道。我们试图在1989年1月至2004年12月在新加坡一家皮肤科第三转诊中心就诊的患有LCMN的患者的回顾性队列中确定黑色素瘤的发生风险。方法：研究对象为覆盖至少5%体表面积的先天性黑色素细胞痣(CMN)患者。数据来自电子记录和照片文件。结果：共有39例患者(男性23例，女性16例)符合LCMN的研究标准，其中15例患者还符合巨大CMN(即成年时直径至少为20 cm的CMN)的标准。其中29例为华裔，6例为马来人，1例为印度人，3例为高加索人。年龄23个月~60岁，平均18.8岁。他们的平均年龄为26个月，平均随访16.9年。LCMN大小占体表面积的5%~40%，平均12.2%。最常见的部位是背部(54%)、下肢(28%)和腹部(26%)。22例患者存在卫星病变。对7例头面部或背部LCMN患者进行了头部或胸腰椎磁共振成像，结果均为正常。只有一名患者接受了治疗：他接受了二氧化碳激光消融，并对其LCMN的一小部分进行了调Q激光治疗。对5例形成结节的患者的皮肤活检进行克隆；组织学检查未显示恶性的证据。限制：增加3名在癌症登记开始前出生的成年患者可能会导致存活者偏见。在我们的研究人群中，由于样本量较小，无法准确估计黑色素瘤的发生风险。结论：在以东南亚为主的队列中，LCMN发生黑色素瘤的风险似乎非常低。预防性完整切除LCMN是理想的，但很少能实现。因此，患者教育、定期黑色素瘤监测和可疑病变的活检是非常重要的。
Background: The lifetime risk of developing melanoma in Caucasian patients with large congenital melanocytic nevi (LCMN) is estimated to be between 4.5% and 10%. Cohort studies of LCMN and the risk of melanoma development in an Asian population are not available.Objective. We sought to determine the risk of melanoma development in a retrospective cohort of patients presenting with LCMN to a dermatology tertiary referral center in Singapore front January 1989 to December 2004.Methods: Patients with congenital melanocytic nevi (CMN) that covered at least 5% of the body surface area were included in the study. Data were obtained from electronic records and photographic documentation. A search for malignancy was clone using the National Cancer Registry database.Results: In all, 39 patients (23 male and 16 female) met the study criteria of LCMN 15 of 39 patients also met the criteria of having a giant CMN (ie a CMN that is predicted to be at least 20-cm diameter in adulthood). There were 29 Chinese, 6 Malay 1 Indian, and 3 Caucasian patients. Their ages ranged from 23 months to 60 years (mean 18.8 years). They presented at a mean age of 26 months and were followed up for an average of 16.9 years. The size of the LCMN ranged from 5% to 40% Of body surface area, with a mean of 12.2%. The most common sites were the back (54%), lower limb (28%), and abdomen (26%). Satellite lesions were present in 22 patients. Magnetic resonance imaging Of the head Or thoracolumbar spine was performed in 7 patients with LCMN on the scalp/face or back, respectively; all produced normal findings. Only one patient was treated: he had carbon-dioxide laser ablation and Q-switched neodymium:yttrium-aluminum-garnet laser treatment of a small part of his LCMN. Skin biopsies were clone in 5 patients who had developed nodules; histology showed no evidence of malignancy. No patients had developed any form of malignancy.Limitations: The addition of 3 adult patients born before the start of the cancer registry may have led to survivor bias. The small sample size did not allow a precise estimate of the risk of melanoma development in our study population.Conclusion: The risk of melanoma development in LCMN within a predominantly Southeast Asian cohort appears to be very low. Prophylactic complete excision of LCMN is ideal, but seldom achievable. Hence, patient education, regular melanoma surveillance, and biopsy of suspicious lesions are very important.