多発性原発性メラノーマの臨床病理学的特徴とリスク要因
Cristina R Ferrone1, Leah Ben Porat, Katherine S Panageas
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
JAMA
|October 6, 2005
まとめ
メラノーマの既往歴と,家族歴やディスプラスティックネボなどの特定の危険因子を持つ患者は,多発性一次性メラノーマ (MPM) の発生率が高くなります. 集中スクリーニングによる早期発見は,これらの高リスクの個人にとって非常に重要です.
科学分野:
- 皮膚科 皮膚科について
- 腫瘍学 腫瘍学
- 遺伝学 遺伝学とは
背景:
- 多発性一次性メラノーマ (MPM) の発生率は変化しており,既存の研究では特定の危険因子について明確性が欠けている.
- これらの要因を理解することは,効果的な患者管理とリスクの階層化に不可欠です.
研究 の 目的:
- 多発性原発性メラノーマ (MPM) の発生率を将来的な単一機関データベースを使用して決定する.
- MPMに関連する臨床的,病理学的特徴と特定のリスク要因を特定する.
- 後の原発性メラノーマを発症するリスクを分析する.
主な方法:
- メモリアル・スローン・ケタリングがんセンターの多学科データベースの展望レビュー.
- 1996年から2002年の間に初めてメラノーマと診断された4484人の患者を分析した.
- MPM発症の危険因子の特定と評価,家族歴および不形成性ネビを含む.
主要な成果:
- MPMの発生率は8.6%で,患者当たり平均2.3件のメラノーマであった.
- 陽性な家族歴 (21%) またはディスプラスティックネボ (38%) を有する患者は,単発原発性メラノーマ (SPM) 患者と比較してMPMの発生率が有意に高かった (それぞれ12%と18%).
- 第2次原発性メラノーマ発症の5年間のリスクは全体で11.4%で,家族歴が陽性な患者では19.1%に増加し,不形成性ネビウを持つ患者では23.7%に増加しました.
結論:
- 陽性な家族歴および/またはディスプラスティックネボの存在は,多発性一次性メラノーマを発症する重要なリスク因子です.
- これらの危険因子と診断された患者は,集中的な皮膚学的スクリーニングを必要とします.
- 多発性原発性メラノーマのリスクが高い個体については,遺伝子検査を検討すべきである.
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