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Malignant Melanoma in southern Sweden; Histopathology, Prognosis and Aetiology

Måsbäck, Anna LU (2002)
Abstract (Swedish)
Popular Abstract in Swedish

Ändamålet med studien var att identifiera prognostiska och etiologiska riskfaktorer för melanom och dess relation till histopatologi. Studie 1-3 innefattade 711 patienter från 1965-1989. Vi fann en mediantjocklek som varierade mellan 1,1 och 1,4 mm, utan något statistiskt förändring genom åren och en ökning av andelen tunna tumörer (<0,8 mm) som var statistiskt signifikant. Vidare sågs en ökning av andelen tumörer med måttlig/uttalad inflammation samt ökad medianålder vid diagnos. Faktorer som signifikant förbättrade prognosen var; tunnar tumörer, frånvaro av ulceration, kvinnligt kön, tumör lokaliserad till extremiteterna, yngre ålder samt måttlig/uttalad inflammation. Korrelation mellan... (More)
Popular Abstract in Swedish

Ändamålet med studien var att identifiera prognostiska och etiologiska riskfaktorer för melanom och dess relation till histopatologi. Studie 1-3 innefattade 711 patienter från 1965-1989. Vi fann en mediantjocklek som varierade mellan 1,1 och 1,4 mm, utan något statistiskt förändring genom åren och en ökning av andelen tunna tumörer (<0,8 mm) som var statistiskt signifikant. Vidare sågs en ökning av andelen tumörer med måttlig/uttalad inflammation samt ökad medianålder vid diagnos. Faktorer som signifikant förbättrade prognosen var; tunnar tumörer, frånvaro av ulceration, kvinnligt kön, tumör lokaliserad till extremiteterna, yngre ålder samt måttlig/uttalad inflammation. Korrelation mellan olika faktorer sågs, t.ex. tumörlokalisation företrädelsevis på ryggen hos män och på benen hos kvinnor, LMM (Lentiginöst Malignt Melanom) sågs i kombination med hög ålder och tumörlokalisation i ansiktet. Vidare fanns det en relation mellan tjockare tumörer, djupare invasion, nodulär typ (NM), ulceration och hög ålder, samt mellan inflammerade tumörer och tunnare tumörtjocklek, yngre ålder, manligt kön, lokalisation på ”icke-extremiteter” och frånvaro av naevusceller i tumören. Studie 4, inkluderande en fall-kontroll studie på 366 CMM patienter, visade att familjär anamnes på CMM var signifikant relaterad till tunna tumörer (<0,8 mm), tumörlokal på bålen och icke-signifikant associerad till ung ålder vid diagnos. Vidare var risken för att utveckla SSM-typ signifikant ökad vid fräknighet, upphöjda naevus på underarmen, solbrännskador och minskad vid utomhusarbete. Tumör-typen med nodulärt växtsätt (NM) var associerad med närvaro av upphöjda naevi på underarmen samt solbrännskador. Frånvaro av naevusceller i tumören visade en signifikant korrelation med solbrännskador och, oväntat, närvaron av upphöjda naevi. Risken att utveckla CMM efter solbrännskada var något högre i ansiktet och hos äldre människor. Studie 5, omfattade initiala, primära CMM från personer tillhörande familjer med CDKN2A-mutation. Var och en med 3 matchade kontroller. Invasionsnivån (enl. Clark) var signifikant lägre för fallen jämfört med kontrollerna. Inga skillnader sågs dock för tumörtjocklek. Fallen visade även större benägenhet att ha lite eller ingen inflammation eller regression i tumörerna. Jämfört med ett populationsbaserat material (n=667), var fallen signifikant yngre vid diagnos (medianålder 42 jfr. 61 år) och hade mindre förekomst av regressiva förändringar tumörerna. Ingen signifikant skillnad sågs för tumörtjocklek. (Less)
Abstract
The purpose was to study the prognostic and aetiologic risk factors for melanoma in correlation to histopathology. Paper 1-3: Thin tumours (<0.8 mm), tumours with inflammation and median age at diagnosis were signifcantly increasing in 711 CMM patients during the period 1965-89. No difference was found in median thickness. Factors that significantly improved prognosis were; thin tumour thickness, absence of ulceration, female gender, tumour location on extremities, young age and moderate/much tumour inflammation. Correlations between different factors were found, e.g. tumour localisation predominating on the back in males and on the legs in females. LMM (Lentiginous Malignant Melanoma) was seen in combination of old age and facial... (More)
The purpose was to study the prognostic and aetiologic risk factors for melanoma in correlation to histopathology. Paper 1-3: Thin tumours (<0.8 mm), tumours with inflammation and median age at diagnosis were signifcantly increasing in 711 CMM patients during the period 1965-89. No difference was found in median thickness. Factors that significantly improved prognosis were; thin tumour thickness, absence of ulceration, female gender, tumour location on extremities, young age and moderate/much tumour inflammation. Correlations between different factors were found, e.g. tumour localisation predominating on the back in males and on the legs in females. LMM (Lentiginous Malignant Melanoma) was seen in combination of old age and facial tumour site. Further there was a relation between thicker tumours and deeper invasion, nodular type (NM), ulceration and older age. Tumours with inflammation were related to thinner tumours, younger age, male sex, location on non-extremities and absence of naevus cells. Paper 4: In a case-control study including 366 CMM patients, a history of melanoma in the family was significantly related to thin tumours (<0.8 mm), tumour site on the trunk and non-significantly associated to younger age at diagnosis. Further the risk for developing SSM-type was significantly increased with the tendency to freckle, raised naevi, propensity to sunburn and decreased with out-door occupation. The NM-type was associated with the presence of raised naevi on the forearm and to sunburn. Absence of naevus cells in the tumour had a significant correlation to sunburn and the presence of raised naevi. Paper 5: From families with CDKN2A-mutation 26 CMM patients were identified and matched with each 3 controls. The invasive level according to Clark was significantly lower among cases compared to controls. No significant differences were seen for tumour thickness. Compared to a population-based material (n=667), cases were significantly younger at diagnosis (median age 42 vs. 61 years) and had less regressive reaction in their tumours. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Sander, Birgitta, Lab. klin. pat och cyt.,Huddinge sjukhus, 141 86 Huddinge, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
General pathology, pathological anatomy, Patologi (allmän), patologisk anatomi, constitutional factors., ulceration, tumour thickness, mutation, CDKN2A, aetiology, epidemiology, prognosis, survival, Malignant melanoma, histopathology
pages
118 pages
publisher
MD Anna Måsbäck, Dept. of Pathology, University Hospital, SE 221 85 Lund, Sweden,
defense location
the Department of Pathology, Sölveg. 25, Lund, Sweden
defense date
2002-04-16 10:15
ISBN
91-631-2111-5
language
English
LU publication?
yes
id
1d476da5-1c93-4ffa-b24e-432194357ff9 (old id 464455)
date added to LUP
2007-10-02 14:53:20
date last changed
2016-09-19 08:45:13
@misc{1d476da5-1c93-4ffa-b24e-432194357ff9,
  abstract     = {The purpose was to study the prognostic and aetiologic risk factors for melanoma in correlation to histopathology. Paper 1-3: Thin tumours (&lt;0.8 mm), tumours with inflammation and median age at diagnosis were signifcantly increasing in 711 CMM patients during the period 1965-89. No difference was found in median thickness. Factors that significantly improved prognosis were; thin tumour thickness, absence of ulceration, female gender, tumour location on extremities, young age and moderate/much tumour inflammation. Correlations between different factors were found, e.g. tumour localisation predominating on the back in males and on the legs in females. LMM (Lentiginous Malignant Melanoma) was seen in combination of old age and facial tumour site. Further there was a relation between thicker tumours and deeper invasion, nodular type (NM), ulceration and older age. Tumours with inflammation were related to thinner tumours, younger age, male sex, location on non-extremities and absence of naevus cells. Paper 4: In a case-control study including 366 CMM patients, a history of melanoma in the family was significantly related to thin tumours (&lt;0.8 mm), tumour site on the trunk and non-significantly associated to younger age at diagnosis. Further the risk for developing SSM-type was significantly increased with the tendency to freckle, raised naevi, propensity to sunburn and decreased with out-door occupation. The NM-type was associated with the presence of raised naevi on the forearm and to sunburn. Absence of naevus cells in the tumour had a significant correlation to sunburn and the presence of raised naevi. Paper 5: From families with CDKN2A-mutation 26 CMM patients were identified and matched with each 3 controls. The invasive level according to Clark was significantly lower among cases compared to controls. No significant differences were seen for tumour thickness. Compared to a population-based material (n=667), cases were significantly younger at diagnosis (median age 42 vs. 61 years) and had less regressive reaction in their tumours.},
  author       = {Måsbäck, Anna},
  isbn         = {91-631-2111-5},
  keyword      = {General pathology,pathological anatomy,Patologi (allmän),patologisk anatomi,constitutional factors.,ulceration,tumour thickness,mutation,CDKN2A,aetiology,epidemiology,prognosis,survival,Malignant melanoma,histopathology},
  language     = {eng},
  pages        = {118},
  publisher    = {ARRAY(0x999bb38)},
  title        = {Malignant Melanoma in southern Sweden; Histopathology, Prognosis and Aetiology},
  year         = {2002},
}