背景:与黑色素瘤的其他组织病理学亚型相比,恶性黑色素瘤(LM)表现出特定的流行病学特征,倾向于头颈部区域,诊断时平均年龄较高。很少有小规模研究专门评估LM发展的风险因素。
目的:本研究旨在比较LM与黑色素瘤的其他组织学亚型的已知黑色素瘤危险因素的患病率,包括色素特征,职业阳光照射史,痣伯爵,家族性黑色素瘤病史.
方法:我们对152例LM患者和784例其他黑色素瘤亚型(OM)患者进行了病例对照研究。采用Mann-Whitneyt检验和Pearson卡方检验检测两组在连续变量和分类变量上的差异,分别。然后构建单变量和多变量逻辑回归模型以确定与其他黑色素瘤亚型相比发展LM的危险因素。
结果:在多变量逻辑回归分析中,与OM相比,LM与lentyines计数>50和职业性阳光暴露呈正相关(分别为OR2.10,95%CI1.35-3.29和OR2.18,95%CI1.33-3.57)。相比之下,与OM相比,痣计数增加且皮肤颜色白皙或中等的患者发生LM的可能性较小(OR分别为0.93,P<0.001,95%CI0.91~0.94和OR0.28,P<0.001,95%CI0.17~0.46).在单变量分析中,与OM相比,LM与所有色素性状的关联较弱。未发现非典型痣计数和家族史的显着关联。
结论:我们发现LM和其他黑色素瘤亚型之间已知黑色素瘤危险因素的患病率存在显著差异,这支持了LM独特致病途径的假设。
BACKGROUND: Lentigo maligna (LM) exhibits a particular epidemiological profile compared to other histopathologic subtypes of melanoma, with a propensity for the head and neck area and a higher mean age at diagnosis. Few small-scale studies have exclusively evaluated the risk factors for the development of LM.
OBJECTIVE: This study aims to compare LM to other histological subtypes of melanoma for the prevalence of known melanoma risk factors, including pigmentary characteristics, history of occupational sun exposure, nevus count, and familial melanoma history.
METHODS: We conducted a case-control study of 152 patients with LM and 784 patients with other melanoma subtypes (OM). The Mann-Whitney t-test and Pearson chi-squared test were used to detect differences between the two groups in continuous and categorical variables, respectively. Univariate and multivariate logistic regression models were then constructed to identify risk factors for developing LM compared to other melanoma subtypes.
RESULTS: In multivariate logistic regression analysis, LM was positively associated with a lentigines count >50 and occupational sun exposure compared to OM (OR 2.10, 95% CI 1.35-3.29 and OR 2.18, 95% CI 1.33-3.57, respectively). In contrast, patients with an increased nevus count and fair or medium skin color were less likely to develop LM than OM (OR 0.93, P < 0.001, 95% CI 0.91-0.94, and OR 0.28, P < 0.001, 95% CI 0.17-0.46, respectively). In univariate analysis, LM exhibited a weaker association with all pigmentary traits than OM. No significant associations were found for atypical nevi count and family history.
CONCLUSIONS: We found significant differences in the prevalence of known melanoma risk factors between LM and other melanoma subtypes, which supports the hypothesis of a distinct pathogenetic pathway of LM.