原发性多发性黑色素瘤:一项2年人群调查结果  

Multiple primary melanoma: Two-year results from a population-based study

作　　者：Titus-Ernstoff L. Perry A.E. Spencer S.K. 王琼 

机构地区：[1]Department of Community and Family Medicine, Dartmouth Medical School, Norris Cotton Cancer Center, 1 Medical Center Dr, Lebanon, NH 03756, United States Dr.

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第8期24-25,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Objective: To assess the frequency of occurrence and risk factors for multiple primary melanoma. Design: Population-based, case-control study. Setting: New Hampshire. Participants: Three-hundred fifty-four New Hampshire residents with a confirmed first diagnosis of cutaneous melanoma. Main Outcome Measure: Diagnosis of a subsequent primary cutaneous melanoma. Results: An additional melanoma occurred in 27 individuals (8% ) within 2 years of their initial diagnosis, including 20 (6% ) within the first postdiagnosis year. In 9 (33% ) of these 27 cases, at least 1 subsequent melanoma was deeper than the first tumor. The 27 individuals with a subsequent melanoma diagnosis were classified as “ cases” and were compared on the basis of risk factors to the 327 “ controls” with a single melanoma diagnosis. The data indicate an inverse relation of risk of multiple primary melanomas with multiple blistering sunburns (P=.01 for the trend); the odds ratio (OR) was 0.32 (95% confidence interval [CI], 0.11- 0.93) for 2 or more sunburns compared with none. The number of atypical moles was significantly related to increased risk (P=.004 for the trend). The presence of 3 ormore atypical moles comparedwith none was associated with more than a 4-fold risk of multiple primary melanomas (OR, 4.29; 95% CI, 1.51- 12.16). Conclusions: Additional melanomas occur more frequently than previously shown. Our study confirms that atypical moles are strongly associated with risk of multiple primary melanomas but provides little evidence that risk is influenced by pigmentary characteristics, hours of sun exposure, or benign moles. The inverse association with blistering sunburn may reflect the influence of an unmeasured covariate.Objective： To assess the frequency of occurrence and risk factors for multiple primary melanoma. Design： Population-based, casecontrol study. Setting： New Hampshire. Participants： Three-hundred fifty-four New Hampshire residents with a confirmed first diagnosis of cutaneous melanoma. Main Outeome Measure： Diagnosis of a subsequent primary eutaneous melanoma. Results： An additional melanoma oeeurred in 27 individuals （8%） within 2 years of their initial diagnosis, ineluding 20 （6%） within the first postdiagnosis year. In 9 （33%） of these 27 eases, at least 1 subsequent melanoma was deeper than the first tumor. The 27 individuals with a subsequent melanoma diagnosis were elassified as ＂eases＂ and were eompared on the basis of risk faetors to the 327 ＂eontrols＂ with a single melanoma diagnosis. The data indieate an inverse relation of risk of multiple primary melanomas with multiple blistering sunburns （P=.01 for the trend）; the odds ratio （OR） was 0.32 （95% confidence interval [CI], 0. 11 - 0.93） for 2 or more sunburns compared with none. The number of atypical moles was significantly related to increased risk （P =. 004 for the trend） . The presence of 3 ormore atypical moles comparedwith none was associated with more than a 4-fold risk of multiple primary melanomas （OR, 4.29; 95% CI, 1.51 - 12. 16）. Conclusions： Ad- ditional melanomas occur more frequently than previously shown. Our study confirms that atypical moles are strongly associated with risk of multiple primary melanomas but provides little evidence that risk is influenced by pigmentary characteristics, hours of sun exposure,

关 键 词：皮肤黑色素瘤 多发性 原发性 调查结果 人群 病例对照研究 危险因素 观察指标 肿瘤位置 数据显示 

分 类 号：R739.5[医药卫生—肿瘤] R544.1[医药卫生—临床医学]