Early detection of thick melanomas in the United States - Beware of the nodular subtype
Early detection of thick melanomas in the United States - Beware of the nodular subtype
复制标题
DOI：
10.1001/archderm.141.6.745
复制
发表时间：
2005-06-01
影响因子：
--
通讯作者：
Geller, AC
中科院分区：
文献类型：
--
作者：
Demierre, MF;Chung, C;Geller, AC
背景：黑色素瘤的发病率和死亡率在美国急剧上升。部分死亡率的增加可能与生物侵袭性结节性黑色素瘤的晚期检测有关。我们确定了薄和厚黑色素瘤的分布趋势，重点是组织病理学亚型结节性黑色素瘤。方法：1988年至1999年获得了白人黑色素瘤发病率的监测、流行病学和最终结果数据，并根据组织学亚型进行分层：恶性雀斑样痣黑色素瘤、浅表扩散性黑色素瘤、结节性黑色素瘤、其他和未另行说明（NOS）;厚度：0-0.99 mm、1.00 mm-1.99 mm和>= 2.0 mm;患者年龄（0- 49，50+）;性别;和年份（1988 - 1991，1992 - 1995，1996 -1999）。层之间的肿瘤厚度比较定义的诊断，性别，年龄和组织学subtype.Results：在3年期间的新的黑色素瘤病例数增加了60%，从1988-1991年（n = 9132）到1996- 1999年（n = 14 - 5 - 75）。厚黑色素瘤（>= 2 mm）的比例在12年的研究中保持相对稳定。结节性黑色素瘤占所有记录病例的9%，但2 mm或更大的黑色素瘤占34%，包括未另行说明的黑色素瘤（NOS），当排除NOS病例时，占所有2 mm或更大黑色素瘤的近50%。相比之下，浅表扩散性黑色素瘤几乎一致地被诊断为早期肿瘤，大多数（77%）表现为薄黑色素瘤（< 1 mm），只有77%表现为厚黑色素瘤（>= 2 mm）。结论：在美国，大量厚黑色素瘤是结节亚型，结节性黑色素瘤的中位厚度在12年的研究中没有变化。需要新的策略来降低美国厚黑色素瘤的发病率。
Background: Incidence and mortality of melanoma in the United States have risen steeply. Part of this mortality increase may be related to late detection of biologically aggressive nodular melanomas. We determined trends in distribution of thin and thick melanoma, with emphasis on the histopathologic subtype nodular melanoma.Methods: Surveillance, Epidemiology, and End Results melanoma incidence data for whites were obtained for 1988 through 1999 and stratified according to histologic subtype: lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma, other, and not otherwise specified (NOS); thickness: 0-0.99 mm, 1.00 mm-1.99 mm, and >= 2.0 mm; patient age (0-49,50+); gender; and year (19881991,1992-1995,1996-1999). Comparison of tumor thickness between strata was defined by year of diagnosis, sex, age, and histologic subtype.Results: The number of new melanoma cases in a 3-year period increased 60% from 1988-1991 (n = 9132) to 1996- 1999 (n = 14 5 75). The proportion of thick melanomas (>= 2 mm) remained relatively stable during the 12 study years. Nodular melanoma comprised 9% of all recorded cases but 34% of melanomas 2 mm or larger, including melanoma not otherwise specified (NOS), and nearly 50% of all melanomas 2 mm or larger when NOS cases were excluded. In contrast, superficial spreading melanoma was almost uniformly diagnosed as an early tumor, mostly (77%) presenting as thin melanoma (< 1 mm) and with only 77% presenting as thick melanoma (>= 2 mm).Conclusions: A substantial number of thick melanomas in the United States are of the nodular subtype, and median thickness of nodular melanoma has not changed during the 12 years of study. New strategies are needed to decrease the incidence of thick melanoma in the United States.