Acral cutaneous melanoma in caucasians: clinical features, histopathology and prognosis in 112 patients
Acral cutaneous melanoma in caucasians: clinical features, histopathology and prognosis in 112 patients
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DOI：
10.1046/j.1365-2133.2000.03651.x
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发表时间：
2000-08-01
影响因子：
10.3
通讯作者：
Garbe, C
中科院分区：
文献类型：
--
作者：
Kuchelmeister, C;Schaumburg-Lever, G;Garbe, C
肢端雀斑样痣性黑色素瘤（acrallentiginousmelanoma，ALM）是皮肤黑色素瘤的第四种不同类型. ALM.Objectives的组织学诊断和预后的ALM.Objectives回顾了一个大系列的ALM.Objectives患者的特点，并确认这种类型的melanoma.Methods收集了2642例皮肤黑色素瘤患者在1986年至1997年期间，其中187位于肢端网站的有效性。组织学标本进行了审查，在112肢端黑色素瘤，下面的研究是基于这个subgroup.Results组织学检查发现肢端雀斑样黑色素瘤主要是在掌跖和指甲下的位置（60%），而浅表扩散性黑色素瘤（SSM），主要发现在手和足的背面（30%）。结节性黑色素瘤（NM）（9%）发生在所有肢端部位。组织学复查证实了Reed在1976年描述的ALM特征。随着肿瘤厚度的增加，类似地观察到肿瘤细胞的嵌套和向上迁移到皮质层。原发性肢端黑色素瘤无明显转移者5年生存率为82%。ALM与SSM（P = 0.001）和恶性雀斑样痣黑色素瘤（P < 0.001）的生存率有显著性差异，但与NM（P = 0.9）的生存率相似。
Background Acral lentiginous melanoma (ALM) is the fourth distinct variant of cutaneous melanoma. The histological diagnosis and prognosis of ALM are still controversial.Objectives To review the features of a large series of patients with ALM, and confirm the validity of the histological criteria for this type of melanoma.Methods A collection of 2642 patients with cutaneous melanoma was recorded during the period 1986-97, among these 187 were located on acral sites. Histological specimens were reviewed in 112 acral melanomas; the following study is based on this subgroup.Results Histological examination revealed acral lentiginous melanomas predominantly in palmoplantar and subungual locations (60%), while superficial spreading melanomas (SSM) were found mainly on the dorsal aspects of hands and feet (30%). Nodular melanomas (NM) (9%) occurred in all acral sites. The histological re-examination confirmed the characteristics of ALM as described by Reed in 1976. With increasing tumour thickness nesting of tumour cells and upward migration to the cornified layer was similarly observed. The 5-year survival rate for patients with primary acral melanoma without recognizable metastasis was 82%. ALM differed significantly in survival from SSM (P = 0.001) and lentigo maligna melanoma (P < 0.001), but survival rates were similar to NM (P = 0.9).Conclusions ALM, as diagnosed by current histological criteria, occur on the palms, soles and subungual sites, and have a poor prognosis.