中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (10): 850-853.doi: 10.35541/cjd.20220243

• 论著 • 上一篇    下一篇

机械应力与黑素瘤：129例足底黑素瘤的回顾性分析

吴清容    高鑫    鲁丽霞    李芳芳    陈明亮    赵爽    陈翔    粟娟   

  1. 中南大学湘雅医院皮肤科  皮肤健康与疾病湖南省工程研究中心  皮肤肿瘤与银屑病湖南省重点实验室  国家老年疾病临床医学研究中心，长沙  410008
  • 收稿日期:2022-04-12 修回日期:2022-07-08 发布日期:2022-10-08
  • 通讯作者: 粟娟 E-mail:sujuanderm@csu.edu.cn
  • 基金资助:
    国家自然科学基金（81974478、82173009）

Mechanical stress and melanoma: a retrospective analysis of 129 cases of plantar melanoma

Wu Qingrong, Gao Xin, Lu Lixia, Li Fangfang, Chen Mingliang, Zhao Shuang, Chen Xiang, Su Juan   

  1. Department of Dermatology, Xiangya Hospital, Central South University, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, National Clinical Research Center of Geriatric Disorders, Changsha 410008, China
  • Received:2022-04-12 Revised:2022-07-08 Published:2022-10-08
  • Contact: Su Juan E-mail:sujuanderm@csu.edu.cn
  • Supported by:
    National Natural Science Foundation of China（81974478、82173009）

PDF

15

摘要： 【摘要】 目的 探究机械应力在足底黑素瘤形成中的潜在作用。方法 回顾性分析2014—2021年中南大学湘雅医院129例足底黑素瘤的分布位置及临床特征，采用卡方拟合优度检验比较承重区（足趾、足前部、足中部外侧、足跟）与非承重区（足弓）皮损分布的差异，t检验、Fisher精确检验和Wilcoxon秩和检验分析足底承重区与非承重区黑素瘤临床病理特征的差异。结果 129例足底黑素瘤患者中，男66例（51.2%），女63例（48.8%），发病年龄（60.6 ± 13.1）岁。最常见的发病部位是足跟（65个病变，1.31个/cm2），其余依次是足前部（31个病变，0.41个/cm2）、足趾底面（15个病变，0.43个/cm2）、足中部外侧（11个病变，0.38个/cm2）、足弓（7个病变，0.16个/cm2）。卡方拟合优度检验显示，承重区较非承重区更易患黑素瘤（χ2 = 66.59，P < 0.001）；与足弓部相比，足跟和足前部发病密度更高（χ2值分别为38.29、5.23，P值分别＜ 0.001、 = 0.022）。承重区与非承重区足底黑素瘤患者性别、年龄、职业、左/右足受累、皮损Breslow厚度、溃疡情况、Clark分级、淋巴结转移、肿瘤分期等差异均无统计学意义（均P > 0.05）。结论 足底承重区较非承重区更易患黑素瘤，推测机械应力刺激可能与黑素瘤的发生发展有关。

关键词: 黑色素瘤, 机械应力, 临床病理特点

Abstract: 【Abstract】 Objective To analyze potential roles of mechanical stress in the formation of plantar melanoma. Methods A retrospective analysis was conducted on 129 cases of plantar melanoma in Xiangya Hospital, Central South University between 2014 and 2021, and the distribution and clinical characteristics of plantar melanoma were analyzed. The goodness-of-fit test was used to compare the distribution of plantar melanoma between weight-bearing areas （the toes, forefoot, lateral midfoot, heel） and non-weight-bearing areas of the foot （the arch）, while t test, Fisher′s exact test and Wilcoxon rank sum test were used to analyze differences in clinicopathological characteristics of plantar melanoma between weight-bearing areas and non-weight-bearing areas of the foot. Results Among the 129 patients with plantar melanoma, 66 （51.2%） were males and 63 （48.8%） were females, and their age at onset was 60.6 ± 13.1 years. Plantar melanoma mostly occurred on the heel （65 lesions, 1.31 lesions per square centimeter）, followed by the forefoot （31 lesions, 0.41 lesions per square centimeter）, the bottom of the toes （15 lesions, 0.43 lesions per square centimeter）, lateral midfoot （11 lesions, 0.38 lesions per square centimeter） and the arch of foot （7 lesions, 0.16 lesions per square centimeter）. The goodness-of-fit test showed that melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas （χ2 = 66.59, P < 0.001）; compared with the arch of foot, a higher incidence density was observed in the heel and forefoot （χ2 = 38.29, 5.23, P < 0.001, = 0.022, respectively）. There were no significant differences in the gender ratio, age and occupation of patients, prevalence rates of left/right foot involvement, Breslow thickness, ulceration status, Clark grades, lymph node metastasis rate, and stages between melanomas in the weight-bearing areas and those in non-weight-bearing areas （all P > 0.05）. Conclusion Plantar melanoma was more prone to occur in the weight-bearing areas than in the non-weight-bearing areas, suggesting that mechanical stress may be related to the occurrence and development of melanoma.

Key words: Melanoma, Mechanical stress, Clinicopathological characteristics