Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases.
Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases.
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DOI：
10.1038/srep31432
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发表时间：
2016-08-22
影响因子：
4.6
通讯作者：
Kong J
中科院分区：
文献类型：
--
作者：
Lv J;Dai B;Kong Y;Shen X;Kong J
肢端黑色素瘤（AM）作为黑色素瘤的一个特殊亚群，在白种人中很少见，但在亚洲人中发病率较高。关于AM的临床病理特征和预后因素的大型系列研究仍然有限，特别是在亚洲人群中。我们回顾性收集了142例AM病例的临床、病理和随访资料。所有患者均为中国人，年龄从 24 岁到 87 岁不等（平均 62.0；中位 62.0）。原发病灶的 Breslow 厚度范围为 0.6 至 16.3mm（平均 4.9；中位 3.7）。 85.9%的患者具有肢端雀斑样痣组织学亚型。足底是最常受累的部位，其次是脚跟。统计上，诊断前病变持续时间（≤2.5年）、Breslow厚度>4.0 mm（T4）、高有丝分裂指数（>15 mm−2）、存在血管侵犯、诊断时的区域淋巴结转移和病理分期（II/III/IV）在单变量和多变量分析中均被发现是独立的预后因素。中国人AM的预后极差。我们的 5 年和 10 年疾病特异性生存 (DSS) 率分别为 53.3% 和 27.4%。因此，亚洲人的 AM 代表了一种更具生物侵袭性的黑色素瘤亚型，与其他种族或其他解剖部位的皮肤黑色素瘤相比，被认为预后较差。
Acral melanoma (AM), as a peculiar subgroup of melanoma, is rare in Caucasians but has higher incidence in Asians. Large series of study on AM with clinicopathological features and prognostic factors is still limited, especially in Asian population. We retrospectively collected clinical, pathological and follow-up data of 142 AM cases. All patients were Chinese, with the age ranging from 24 to 87 years (mean 62.0; median 62.0). The Breslow thickness of primary lesions ranged from 0.6 to 16.3 mm (mean 4.9; median 3.7). 85.9% of the patients had acral lentiginous histologic subtype. Plantar was the most frequently involved site, followed by heels. Statistically, duration of the lesion before diagnosis (≤2.5 years), Breslow thickness >4.0 mm (T4), high mitotic index (>15 mm−2), presence of vascular invasion, regional lymph node metastasis at diagnosis and pathologic stage (II/III/IV) were found to be independent prognostic factors in both univariate and multivariate analyses. The prognosis of AM in Chinese is extremely poor. Our 5- and 10-year disease-specific survival (DSS) rates were 53.3% and 27.4%, respectively. Therefore, AM in Asians represents a more biologically aggressive melanoma subtype and is thought to carry a worse prognosis when compared with other races or cutaneous melanomas in other anatomic sites.