Despite being early-stage tumors, thin cutaneous melanomas contribute significantly to mortality and have a rising incidence. A retrospective case–control study was performed to identify clinical–dermoscopic and histopathological variables linked to local and distant metastases in melanomas ≤0.8 mm. Data from 1 January 2000 to 22 June 2022 were analyzed from two Italian skin cancer referral centers. Sixteen patients with ≤0.8 mm melanomas developing metastases were studied compared to controls without metastases over 5 years. Statistical analysis involved Pearson’s chi-squared test or Fisher’s exact test. Of the 1396 cases, 1.1% progressed. The median diagnosis age was 49 (range 28–83), with 56.3% men and 43.7% women. The torso was the primary tumor site (43.7%). Clinically, lesions were pigmented (>10 mm diameter: 73.3%, ≥3 colors: 80%). Dermoscopically, the common features were white patches (73.3%), atypical vascular patterns (66.5%), blue-gray areas (60%) and absent pigment networks (60%). Histopathologically, all cases had adverse features like regression (87.4%), dermal mitoses (50%), a vertical growth phase (62.5%) and ulceration (12.5%). These findings were statistically significant compared to controls (p< 0.05). In ≤0.8 mm melanomas, specific clinical–dermoscopic traits might indicate higher metastatic potential when paired with adverse histopathological features.
尽管属于早期肿瘤，薄型皮肤黑色素瘤对死亡率的影响显著且发病率呈上升趋势。本研究通过回顾性病例对照分析，旨在识别与厚度≤0.8毫米黑色素瘤发生局部及远处转移相关的临床-皮肤镜特征与组织病理学变量。研究数据来源于意大利两家皮肤癌转诊中心2000年1月1日至2022年6月22日的病例资料。研究纳入16例发生转移的≤0.8毫米黑色素瘤患者，并与5年内未发生转移的对照组进行比较。统计分析采用皮尔逊卡方检验或费希尔精确检验。在1396例病例中，1.1%出现进展。患者诊断中位年龄为49岁（范围28-83岁），男性占56.3%，女性占43.7%。躯干部位是主要原发部位（43.7%）。临床特征显示：皮损均存在色素沉着（直径>10毫米者占73.3%，≥3种颜色者占80%）。皮肤镜特征主要表现为：白色斑片（73.3%）、非典型血管模式（66.5%）、蓝灰色区域（60%）及色素网络缺失（60%）。组织病理学方面，所有病例均存在不良特征：退行性变（87.4%）、真皮层核分裂象（50%）、垂直生长期（62.5%）和溃疡形成（12.5%）。与对照组相比，这些特征均具有统计学显著性差异（p<0.05）。研究提示，在厚度≤0.8毫米的黑色素瘤中，特定的临床-皮肤镜特征若与不良组织病理学特征并存，可能预示着更高的转移风险。
肿瘤(癌症)患者之家