美国北卡罗来纳大学研究人员4月21日公布的研究成果显示，长在头皮及颈部的恶性黑色素瘤（一种皮肤癌）比长在人体其他部位的恶性黑色素瘤更致命。
研究人员分析了大约5.2万名1992年至2003年间被诊断出患有恶性黑色素瘤美国人的治疗数据，结果发现，这些人的生存率与恶性黑色素瘤最先在他们身上哪个部位出现相关。
研究人员发现，恶性黑色素瘤长在头皮或颈部者的5年期生存率为83%，而恶性黑色素瘤长在其他部位者的5年期生存率为92%；前者的10年期生存率为76%，后者的10年期生存率为89%。
研究人员认为，出现这种现象的原因可能是长在头皮或颈部的恶性黑色素瘤更难得到诊断，也可能是因为出现在这两个部位的恶性黑色素瘤更富有攻击性。他们建议医护人员进行常规皮肤检测时，仔细检测受检者的头皮和颈部。
这项研究成果刊登在21日出版的《皮肤病学档案》（Archives of Dermatology）月刊上。（来源：新华网）
生物谷推荐原始出处：
（Archives of Dermatology），144(4):515-521，Anne M. Lachiewicz，Nancy E. Thomas
Survival Differences Between Patients With Scalp or Neck Melanoma and Those With Melanoma of Other Sites in the Surveillance, Epidemiology, and End Results (SEER) Program
Objective To compare the prognosis of patients with scalp or neck (scalp/neck) melanomas with that of patients with melanomas at other sites in a large, population-based national data set controlling for known prognostic factors.
Design Retrospective cohort study using US cancer registries that constitute the Surveillance, Epidemiology, and End Results 13 Registries (SEER-13) database.
Patients A total of 51 704 non-Hispanic white adults in the United States with a first invasive cutaneous melanoma reported during the period 1992 to 2003.
Main Outcome Measures Kaplan-Meier survival estimates were used to compare melanoma-specific survival by anatomic site at 5 and 10 years. Multivariate Cox models were used to examine the hazard ratio (HR) of melanoma-specific death associated with scalp/neck melanoma compared with melanoma of the extremities after controlling for other variables.
Results The 5- and 10-year Kaplan-Meier survival probabilities for scalp/neck melanoma were 83.1% and 76.2%, respectively, compared with 92.1% and 88.7%, respectively, for melanoma of the other sites, including extremities, trunk, face, and ears (log-rank test; P < .001). In a multivariate Cox model, the patients with melanoma of the scalp/neck died of melanoma at 1.84 times (HR, 1.84; 95% confidence interval, 1.62-2.10) the rate of those with melanoma on the extremities, controlling for age, Breslow thickness, sex, and ulceration. Neither excluding cases of lentigo maligna and nodular melanoma nor controlling for lymph node involvement materially changed the HR for scalp/neck melanoma.
Conclusions A notable survival difference remained between scalp/neck melanoma and melanoma of other sites even after adjustment for important prognostic factors. This finding has implications for screening and public health recommendations, and we urge physicians, physician assistants, nurses, and nurse practitioners to examine the scalp/neck carefully during routine skin examinations. Further studies are needed to understand the biological or environmental factors leading to survival differences by anatomic site.
