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COVID-19 大流行对黑色素瘤诊断的影响:原发性黑色素瘤的 Breslow 厚度增加——单中心经验。

Impact of the COVID-19 Pandemic on Melanoma Diagnosis: Increased Breslow Thickness in Primary Melanomas-A Single Center Experience.

机构信息

Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

Int J Environ Res Public Health. 2022 Dec 14;19(24):16806. doi: 10.3390/ijerph192416806.

Abstract

Early melanoma diagnosis plays a key role in ensuring best prognosis with good survival rates. The ongoing global COVID-19 pandemic has greatly impacted global and national healthcare systems, thus making it a real challenge. The aim of this study was to evaluate the impact of the pandemic on diagnostic delay in melanoma patients in Serbia. In this retrospective study, we included patients treated at the university hospital in Serbia's capitol over a period of five years and three months. We compared the prepandemic (01/JAN/17-14/MAR/20) and pandemic periods (15/MAR/20-31/MAR/22) by evaluating patient demographic data, melanoma subtype, Breslow thickness, Clark level, ulceration status, mitotic index rate and pT staging. We observed a significant reduction in the number of diagnosed patients (86.3 vs. 13.7%; = 0.036), with melanomas having an increased median Breslow thickness (1.80 vs. 3.00; = 0.010), a higher percentage of Clark IV-V level lesions (44.0% vs. 63.0%; = 0.009), an increase in median mitotic index rate (2 vs. 5; < 0.001) and a trend of increase in lesions thicker than 2 mm (37.8% vs. 53.7%; = 0.026). We believe that this study can be a useful scenario guide for future similar events, highlighting the importance of preventive measures and timely diagnosis for the best patient outcomes.

摘要

早期黑色素瘤诊断对于确保最佳预后和高生存率至关重要。持续的全球 COVID-19 大流行极大地影响了全球和国家的医疗保健系统,因此这是一个真正的挑战。本研究旨在评估大流行对塞尔维亚黑色素瘤患者诊断延迟的影响。在这项回顾性研究中,我们纳入了在塞尔维亚首都的大学医院治疗的患者,研究时间为五年零三个月。我们通过评估患者的人口统计学数据、黑色素瘤亚型、Breslow 厚度、Clark 分级、溃疡状态、有丝分裂指数率和 pT 分期,比较了大流行前(2017 年 1 月 1 日至 2020 年 3 月 14 日)和大流行期间(2020 年 3 月 15 日至 22 年 3 月 31 日)的数据。我们观察到诊断出的患者数量显著减少(86.3%比 13.7%;=0.036),黑色素瘤的中位 Breslow 厚度增加(1.80 比 3.00;=0.010),Clark IV-V 级病变的比例更高(44.0%比 63.0%;=0.009),中位有丝分裂指数率增加(2 比 5;<0.001),厚度大于 2 毫米的病变比例呈上升趋势(37.8%比 53.7%;=0.026)。我们认为,这项研究可以为未来类似事件提供有用的情景指南,强调预防措施和及时诊断对最佳患者结局的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81ab/9779520/c0a33237e7c5/ijerph-19-16806-g001.jpg

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