{"id":5270,"date":"2025-09-09T13:14:47","date_gmt":"2025-09-09T04:14:47","guid":{"rendered":"https:\/\/www.hiro-clinic.or.jp\/dermatology\/?p=5270"},"modified":"2025-09-09T13:14:48","modified_gmt":"2025-09-09T04:14:48","slug":"melanoma-basics-risk-diagnosis-stage-treatment","status":"publish","type":"post","link":"https:\/\/www.hiro-clinic.or.jp\/dermatology\/derma\/dermatology-basics\/melanoma-basics-risk-diagnosis-stage-treatment\/","title":{"rendered":"\u6cbb\u7642\u524d\u306b\u77e5\u308a\u305f\u3044\u60aa\u6027\u9ed2\u8272\u816b\u306e\u57fa\u790e\u77e5\u8b58"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p>\u60aa\u6027\u9ed2\u8272\u816b\uff08\u30e1\u30e9\u30ce\u30fc\u30de\uff09\u306f\u3001\u76ae\u819a\u304c\u3093\u306e\u4e2d\u3067\u3082\u6700\u3082\u4fb5\u8972\u6027\u304c\u9ad8\u304f\u3001\u65e9\u671f\u767a\u898b\u3068\u9069\u5207\u306a\u6cbb\u7642\u304c\u751f\u5b58\u7387\u306b\u76f4\u7d50\u3057\u307e\u3059\u3002\u672c\u8a18\u4e8b\u3067\u306f\u3001\u6cbb\u7642\u958b\u59cb\u524d\u306b\u7406\u89e3\u3057\u3066\u304a\u304f\u3079\u304d\u300c\u60aa\u6027\u9ed2\u8272\u816b\u306e\u57fa\u790e\u77e5\u8b58\u300d\u3092\u3001\u539f\u56e0\u3084\u8a3a\u65ad\u3001\u30b9\u30c6\u30fc\u30b8\u5206\u985e\u304b\u3089\u6cbb\u7642\u65b9\u91dd\u3084\u751f\u6d3b\u652f\u63f4\u306b\u81f3\u308b\u307e\u3067\u3001\u5c02\u9580\u6027\u3092\u4fdd\u3061\u3064\u3064\u4e01\u5be7\u306b\u89e3\u8aac\u3057\u307e\u3059\u3002\u3053\u308c\u304b\u3089\u6cbb\u7642\u306b\u5411\u304b\u3046\u65b9\u3001\u3054\u5bb6\u65cf\u3001\u533b\u7642\u95a2\u4fc2\u8005\u306e\u65b9\u306b\u3082\u5f79\u7acb\u3064\u3088\u3046\u3001\u6700\u65b0\u306e\u533b\u5b66\u7684\u6839\u62e0\u3092\u8e0f\u307e\u3048\u3066\u6574\u7406\u3057\u307e\u3057\u305f\u3002<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>1. \u60aa\u6027\u9ed2\u8272\u816b\u3068\u306f\uff1a\u75ab\u5b66\u30fb\u5206\u985e\u30fb\u767a\u751f\u6bcd\u5730<\/strong><\/h2>\n\n\n\n<p>\u60aa\u6027\u9ed2\u8272\u816b\uff08melanoma\uff09\u306f\u3001\u30e1\u30e9\u30ce\u30b5\u30a4\u30c8\u306b\u7531\u6765\u3059\u308b\u76ae\u819a\u304c\u3093\u306e\u4e00\u7a2e\u3067\u3001\u4ed6\u306e\u76ae\u819a\u304c\u3093\u306b\u6bd4\u3079\u3066\u9032\u884c\u901f\u5ea6\u304c\u901f\u304f\u3001\u65e9\u671f\u8ee2\u79fb\u306e\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u70b9\u304c\u7279\u5fb4\u3067\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u75ab\u5b66<\/strong><strong><br><\/strong> \u4e16\u754c\u7684\u306b\u306f\u5e74\u9593\u306b\u6570\u4e07\u4eba\u304c\u65b0\u305f\u306b\u8a3a\u65ad\u3055\u308c\u3001\u65e5\u672c\u56fd\u5185\u3067\u3082\u8fd1\u5e74\u5897\u52a0\u50be\u5411\u306b\u3042\u308a\u307e\u3059\u3002\u7279\u306b\u7d2b\u5916\u7dda\uff08UV\uff09\u3078\u306e\u66dd\u9732\u7fd2\u6163\u304c\u7570\u306a\u308b\u6b27\u7c73\u306b\u6bd4\u3079\u308b\u3068\u3001\u30a2\u30b8\u30a2\u3067\u306f\u767a\u75c7\u7387\u306f\u4f4e\u3081\u3067\u3059\u304c\u3001\u5897\u52a0\u50be\u5411\u306f\u7121\u8996\u3067\u304d\u307e\u305b\u3093\u3002<br><\/li>\n\n\n\n<li><strong>\u5206\u985e<\/strong><strong><br><\/strong> \u4ee3\u8868\u7684\u306a\u5206\u985e\u306b\u306f\u4ee5\u4e0b\u304c\u3042\u308a\u307e\u3059\uff1a<br>\n<ul class=\"wp-block-list\">\n<li>\u8868\u5728\u62e1\u5927\u578b\u30e1\u30e9\u30ce\u30fc\u30de\uff08\u6700\u3082\u4e00\u822c\u7684\uff09<br><\/li>\n\n\n\n<li>\u7d50\u7bc0\u578b\u30e1\u30e9\u30ce\u30fc\u30de\uff08\u6df1\u9054\u5ea6\u304c\u6df1\u304f\u3001\u9032\u884c\u3057\u3084\u3059\u3044\uff09<br><\/li>\n\n\n\n<li>\u30e9\u30b8\u30aa\u30fc\u30c9\u578b\uff08\u7d2b\u5916\u7dda\u975e\u4f9d\u5b58\u578b\uff09<br><\/li>\n\n\n\n<li>\u60aa\u6027\u9ed2\u5b50\u578b\uff08\u660e\u3089\u304b\u306a\u6bcd\u6591\u304b\u3089\u767a\u751f\uff09<br><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p>\u767a\u751f\u90e8\u4f4d\u3068\u3057\u3066\u306f\u76ae\u819a\u304c\u6700\u3082\u591a\u3044\u3067\u3059\u304c\u3001\u7c98\u819c\uff08\u53e3\u8154\u3001\u9f3b\u8154\u3001\u809b\u9580\u5468\u56f2\u3001\u773c\u306e\u3076\u3069\u3046\u819c\u306a\u3069\uff09\u3084\u773c\u5185\u3067\u3082\u767a\u751f\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u975e\u5178\u578b\u7684\u306a\u90e8\u4f4d\u306b\u304a\u3051\u308b\u8a3a\u65ad\u306e\u9045\u308c\u306f\u4e88\u5f8c\u3092\u60aa\u5316\u3055\u305b\u308b\u8981\u56e0\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>2. \u30ea\u30b9\u30af\u8981\u56e0\u3068\u767a\u304c\u3093\u30e1\u30ab\u30cb\u30ba\u30e0<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u7d2b\u5916\u7dda\u66dd\u9732<\/strong><strong><br><\/strong> UV-B\u3001UV-A\u306e\u53cd\u5fa9\u66dd\u9732\u306fDNA\u640d\u50b7\u3092\u84c4\u7a4d\u3057\u3001\u30e1\u30e9\u30ce\u30b5\u30a4\u30c8\u306e\u304c\u3093\u5316\u3092\u4fc3\u9032\u3057\u307e\u3059\u3002\u7279\u306b\u65e5\u713c\u3051\u6b74\uff08\u71b1\u50b7\u3092\u4f34\u3046\u3082\u306e\uff09\u306f\u91cd\u8981\u306a\u30ea\u30b9\u30af\u56e0\u5b50\u3002<br><\/li>\n\n\n\n<li><strong>\u76ae\u819a\u30bf\u30a4\u30d7\u3068\u907a\u4f1d\u7684\u8981\u56e0<\/strong><strong><br><\/strong> \u8272\u767d\u3067\u307b\u304f\u308d\u304c\u591a\u3044\u4eba\u3001\u5bb6\u65cf\u6b74\u306e\u3042\u308b\u4eba\u306f\u30ea\u30b9\u30af\u304c\u9ad8\u307e\u308a\u307e\u3059\u3002BRCA\u3001CDKN2A\u3001BRAF\u306a\u3069\u306e\u907a\u4f1d\u5b50\u5909\u7570\u306f\u3001\u5bb6\u65cf\u6027\u30e1\u30e9\u30ce\u30fc\u30de\u3084\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u30bf\u30a4\u30d7\u306b\u95a2\u4e0e\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<br><\/li>\n\n\n\n<li><strong>\u514d\u75ab\u72b6\u614b<\/strong><strong><br><\/strong> \u79fb\u690d\u5f8c\u3084\u514d\u75ab\u6291\u5236\u7642\u6cd5\u4e2d\u306e\u60a3\u8005\u3001HIV\u611f\u67d3\u8005\u3067\u306f\u60aa\u6027\u9ed2\u8272\u816b\u306e\u767a\u75c7\u7387\u30fb\u9032\u884c\u7387\u304c\u4e0a\u6607\u3059\u308b\u5831\u544a\u304c\u3042\u308a\u307e\u3059\u3002<br><\/li>\n<\/ul>\n\n\n\n<p>\u767a\u304c\u3093\u306e\u5206\u5b50\u7684\u6a5f\u69cb\u3068\u3057\u3066\u306f\u3001BRAF V600E\u5909\u7570\u306a\u3069\u306b\u3088\u308bMAPK\u7d4c\u8def\u306e\u6d3b\u6027\u5316\u3001NRAS\u5909\u7570\u3001KIT\u5909\u7570\u306a\u3069\u304c\u77e5\u3089\u308c\u3066\u304a\u308a\u3001\u7279\u306bBRAF\u5909\u7570\u306f\u6cbb\u7642\u6a19\u7684\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>3. \u8a3a\u65ad\u306e\u6d41\u308c\uff1a\u8996\u8a3a\u304b\u3089\u751f\u691c\u3001\u753b\u50cf\u691c\u67fb\u307e\u3067<\/strong><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>\u8996\u8a3a\u3068\u30c0\u30fc\u30e2\u30b9\u30b3\u30d4\u30fc\u691c\u67fb<\/strong><strong><br><\/strong> \u76ae\u819a\u306eABCDEF\u30eb\u30fc\u30eb\uff08Asymmetry\uff08\u975e\u5bfe\u79f0\u6027\uff09\u3001Border\uff08\u5883\u754c\uff09\u3001Color\uff08\u8272\u306e\u591a\u69d8\u6027\uff09\u3001Diameter\uff08\u76f4\u5f84\uff09\u3001Evolving\uff08\u5909\u5316\uff09\u3001Funny looking lesion\uff09\u306b\u57fa\u3065\u3044\u3066\u8996\u8a3a\u3002<br><\/li>\n\n\n\n<li><strong>\u751f\u691c\uff08excisional biopsy\uff09<\/strong><strong><br><\/strong> \u7591\u308f\u3057\u3044\u75c5\u5909\u306b\u3064\u3044\u3066\u306f\u3001\u53ef\u80fd\u306a\u9650\u308a\u5b8c\u5168\u5207\u9664\u306e\u5f62\u3067\u751f\u691c\u3092\u884c\u3044\u3001\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u6df1\u9054\u5ea6\uff08Breslow\u539a\uff09\u3001\u7e01\u6d78\u6f64\u3001\u6709\u830e\u306e\u6709\u7121\u3001\u58ca\u6b7b\u306a\u3069\u3092\u8a55\u4fa1\u3057\u307e\u3059\u3002<br><\/li>\n\n\n\n<li><strong>\u753b\u50cf\u8a55\u4fa1<\/strong><strong><br><\/strong> \u6df1\u9054\u5ea6\u306b\u3088\u3063\u3066\u306f\u3001CT\u3084MRI\u3001FDG-PET\/CT\u306b\u3088\u308b\u30ea\u30f3\u30d1\u7bc0\u8ee2\u79fb\u30fb\u9060\u9694\u8ee2\u79fb\u306e\u691c\u7d22\u304c\u5fc5\u8981\u3067\u3059\u3002\u7279\u306bBreslow\u539a\u304c\u6df1\u3044\u4f8b\u3084\u7d50\u7bc0\u578b\u3067\u306f\u3001\u8853\u524d\u691c\u67fb\u304c\u6cbb\u7642\u65b9\u91dd\u306b\u5927\u304d\u304f\u5f71\u97ff\u3057\u307e\u3059\u3002<br><\/li>\n\n\n\n<li><strong>\u5206\u5b50\u751f\u7269\u5b66\u7684\u691c\u67fb<\/strong><strong><br><\/strong> \u816b\u760d\u7d44\u7e54\u306b\u5bfe\u3057\u3066\u3001BRAF\u3001NRAS\u3001KIT\u306a\u3069\u306e\u907a\u4f1d\u5b50\u5909\u7570\uff08\u304a\u3088\u3073PD-L1\u767a\u73fe\u306a\u3069\uff09\u3092\u8a55\u4fa1\u3057\u3001\u5f8c\u306b\u9078\u629e\u3059\u308b\u85ac\u7269\u6cbb\u7642\u306e\u53c2\u8003\u3068\u3057\u307e\u3059\u3002<br><\/li>\n<\/ol>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>4. \u30b9\u30c6\u30fc\u30b8\u5206\u985e\u3068\u305d\u306e\u610f\u7fa9<\/strong><\/h2>\n\n\n\n<p>\u56fd\u969b\u7684\u306b\u306fAJCC\uff08American Joint Committee on Cancer\uff09\u5206\u985e\u304c\u5e83\u304f\u7528\u3044\u3089\u308c\u3001\u30b9\u30c6\u30fc\u30b80\uff08\u539f\u767a\u90e8\u4f4d\u306e\u307f\uff09\u304b\u3089\u30b9\u30c6\u30fc\u30b8IV\uff08\u9060\u9694\u8ee2\u79fb\u3042\u308a\uff09\u307e\u3067\u6bb5\u968e\u5206\u3051\u3055\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>0\u2013\u2160\u671f<\/strong>\uff1a\u539f\u767a\u5de3\u304c\u6d45\u304f\u3001\u30ea\u30f3\u30d1\u7bc0\u30fb\u9060\u9694\u8ee2\u79fb\u306a\u3057<br><\/li>\n\n\n\n<li><strong>\u2161\u671f<\/strong>\uff1a\u539a\u3044\u539f\u767a\u5de3\uff08Breslow\u539a\u304c\u6df1\u3044\uff09\u3067\u3082\u8ee2\u79fb\u306a\u3057<br><\/li>\n\n\n\n<li><strong>\u2162\u671f<\/strong>\uff1a\u30ea\u30f3\u30d1\u7bc0\u307e\u305f\u306f\u76ae\u819a\u30fb\u30ea\u30f3\u30d1\u7bc0\u5468\u56f2\u8ee2\u79fb\u3042\u308a<br><\/li>\n\n\n\n<li><strong>\u2163\u671f<\/strong>\uff1a\u9060\u9694\u81d3\u5668\u8ee2\u79fb\u3042\u308a<br><\/li>\n<\/ul>\n\n\n\n<p>\u30b9\u30c6\u30fc\u30b8\u306b\u3088\u3063\u3066\u6cbb\u7642\u9078\u629e\u80a2\uff08\u624b\u8853\u306e\u307f\u3001\u8853\u5f8c\u88dc\u52a9\u7642\u6cd5\u3001\u5168\u8eab\u7642\u6cd5\u3001\u7de9\u548c\u30b1\u30a2\u306a\u3069\uff09\u3084\u4e88\u5f8c\u304c\u5927\u304d\u304f\u7570\u306a\u308b\u305f\u3081\u3001\u6b63\u78ba\u306a\u30b9\u30c6\u30fc\u30b8\u8a3a\u65ad\u306f\u6975\u3081\u3066\u91cd\u8981\u3067\u3059\u3002<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>5. \u6cbb\u7642\u6cd5\u306e\u6982\u8981\uff1a\u5c40\u6240\u7642\u6cd5\u304b\u3089\u5168\u8eab\u7642\u6cd5\u307e\u3067<\/strong><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>5-1. \u5c40\u6240\u7642\u6cd5\uff08\u65e9\u671f\uff0f\u539f\u767a\u5de3\u5b58\u5728\u6642\uff09<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u5916\u79d1\u7684\u5207\u9664<\/strong><strong><br><\/strong> \u6a19\u6e96\u7684\u306a\u6cbb\u7642\u306f\u539f\u767a\u5de3\u3092\u5341\u5206\u306a\u30de\u30fc\u30b8\u30f3\uff081\uff5e2cm\u3001\u6df1\u3055\u306b\u3088\u308a\uff09\u3067\u5207\u9664\u3059\u308b\u5916\u79d1\u7642\u6cd5\u3067\u3059\u3002\u30ea\u30f3\u30d1\u7bc0\u90ed\u6e05\u3084\u30bb\u30f3\u30c1\u30cd\u30eb\u30ea\u30f3\u30d1\u7bc0\u751f\u691c\uff08SLNB\uff09\u306f\u3001\u30b9\u30c6\u30fc\u30b8\u8a55\u4fa1\u3068\u4e88\u5f8c\u4e88\u6e2c\u306b\u3082\u5f79\u7acb\u3061\u307e\u3059\u3002<br><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>5-2. \u88dc\u52a9\u7642\u6cd5\uff08\u9ad8\u30ea\u30b9\u30af\u539f\u767a\u5de3\u3084\u30ea\u30f3\u30d1\u7bc0\u967d\u6027\u4f8b\uff09<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u514d\u75ab\u7642\u6cd5\uff08\u6297PD-1\u6297\u4f53\u30fb\u6297CTLA-4\u6297\u4f53\uff09<\/strong><strong><br><\/strong> \u30cb\u30dc\u30eb\u30de\u30d6\uff08\u6297PD\u20111\uff09\u3001\u30a4\u30d4\u30ea\u30e0\u30de\u30d6\uff08\u6297CTLA\u20114\uff09\u306a\u3069\u304c\u4f7f\u7528\u3055\u308c\u3001\u7279\u306b\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u3067\u518d\u767a\u3092\u6291\u3048\u308b\u305f\u3081\u306e\u8853\u5f8c\u88dc\u52a9\u7642\u6cd5\u3068\u3057\u3066\u6709\u52b9\u6027\u304c\u793a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<br><\/li>\n\n\n\n<li><strong>\u5206\u5b50\u6a19\u7684\u7642\u6cd5<\/strong><strong><br><\/strong> \u816b\u760d\u304cBRAF\u5909\u7570\u967d\u6027\u306e\u5834\u5408\u3001BRAF\u963b\u5bb3\u85ac\uff0bMEK\u963b\u5bb3\u85ac\u306e\u4f75\u7528\u7642\u6cd5\uff08\u4f8b\uff1a\u30c0\u30d6\u30e9\u30d5\u30a7\u30cb\u30d6\uff0b\u30c8\u30e9\u30e1\u30c1\u30cb\u30d6\uff09\u304c\u3001\u518d\u767a\u30ea\u30b9\u30af\u3092\u8457\u3057\u304f\u4f4e\u6e1b\u3057\u307e\u3059\u3002<br><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>5-3. \u5168\u8eab\u7642\u6cd5\uff08\u9032\u884c\u30fb\u8ee2\u79fb\u4f8b\uff09<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>\u514d\u75ab\u30c1\u30a7\u30c3\u30af\u30dd\u30a4\u30f3\u30c8\u963b\u5bb3\u7642\u6cd5<\/strong><strong><br><\/strong> \u9032\u884c\u6027\u30fb\u8ee2\u79fb\u6027\u30e1\u30e9\u30ce\u30fc\u30de\u3067\u306e\u6a19\u6e96\u6cbb\u7642\u3067\u3001\u5358\u5264\u307e\u305f\u306f\u7d44\u307f\u5408\u308f\u305b\uff08\u4f8b\uff1a\u30cb\u30dc\u30eb\u30de\u30d6\uff0b\u30a4\u30d4\u30ea\u30e0\u30de\u30d6\uff09\u304c\u884c\u308f\u308c\u307e\u3059\u3002<br><\/li>\n\n\n\n<li><strong>\u5206\u5b50\u6a19\u7684\u6cbb\u7642<\/strong><strong><br><\/strong> BRAF\u5909\u7570\u967d\u6027\u306b\u5bfe\u3057\u3066\u306fBRAF\uff0bMEK\u963b\u5bb3\u85ac\u304c\u7b2c\u4e00\u9078\u629e\u3002\u5909\u7570\u9670\u6027\u306e\u5834\u5408\u306fKIT\u963b\u5bb3\u85ac\uff08KIT\u5909\u7570\u4f8b\uff09\u3084\u305d\u306e\u4ed6\u81e8\u5e8a\u8a66\u9a13\u306e\u9078\u629e\u80a2\u3092\u691c\u8a0e\u3002<br><\/li>\n\n\n\n<li><strong>\u305d\u306e\u4ed6\u306e\u6cbb\u7642<\/strong><strong><br><\/strong> \u4ee5\u524d\u306f\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3\u3084IL-2\u7642\u6cd5\u304c\u7528\u3044\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u304c\u3001\u526f\u4f5c\u7528\u306e\u89b3\u70b9\u304b\u3089\u73fe\u5728\u3067\u306f\u9650\u5b9a\u7684\u306a\u4f7f\u7528\u3067\u3059\u3002\u653e\u5c04\u7dda\u7642\u6cd5\u306f\u5c40\u6240\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3084\u75bc\u75db\u7de9\u548c\u76ee\u7684\u3067\u7528\u3044\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<br><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>6. \u4e88\u5f8c\u3068\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u4f53\u5236<\/strong><\/h2>\n\n\n\n<p><strong>\u4e88\u5f8c<\/strong>\u306f\u30b9\u30c6\u30fc\u30b8\u306b\u4f9d\u5b58\u3057\u3001\u4f8b\u3048\u3070\u2160\u671f\u3067\u306f5\u5e74\u751f\u5b58\u7387\u304c90%\u4ee5\u4e0a\u3067\u3042\u308b\u4e00\u65b9\u3001\u2163\u671f\u3067\u306f10\u201320%\u3068\u3055\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u4e88\u5f8c\u306b\u5f71\u97ff\u3059\u308b\u8981\u7d20\u3068\u3057\u3066\u306fBreslow \u539a\u3001\u6f70\u760d\u5f62\u6210\u3001\u30ea\u30f3\u30d1\u7ba1\u30fb\u8840\u7ba1\u4fb5\u8972\u3001\u30ea\u30f3\u30d1\u7bc0\u8ee2\u79fb\u306e\u6709\u7121\u3001\u5206\u5b50\u7684\u7279\u5fb4\uff08\u4f8b\uff1aBRAF\u5909\u7570\u306e\u6709\u7121\uff09\u306a\u3069\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p><strong>\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7<\/strong>\u3067\u306f\u3001\u521d\u671f\u6570\u5e74\u9593\u306f3\u301c6\u30f6\u6708\u3054\u3068\u306b\u8a3a\u5bdf\uff08\u76ae\u819a\u30fb\u30ea\u30f3\u30d1\u7bc0\u30fb\u753b\u50cf\u691c\u67fb\uff09\u3092\u884c\u3044\u3001\u305d\u306e\u5f8c\u306f\u5e741\u301c2\u56de\u7a0b\u5ea6\u306b\u9593\u9694\u3092\u7a7a\u3051\u308b\u306e\u304c\u4e00\u822c\u7684\u3067\u3059\u3002\u518d\u767a\u306e\u65e9\u671f\u767a\u898b\u306b\u52a0\u3048\u3001\u8853\u5f8c\u306e\u5fc3\u7406\u7684\u30b1\u30a2\u3084\u751f\u6d3b\u6307\u5c0e\u3001\u65e5\u713c\u3051\u6b62\u3081\u306e\u4f7f\u7528\u6307\u5c0e\u306a\u3069\u304c\u91cd\u8981\u3067\u3059\u3002<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"427\" src=\"\/dermatology\/wp-content\/uploads\/2025\/03\/28436579_s.jpg\" alt=\"\u5973\u6027\u9854\" class=\"wp-image-4621\" srcset=\"https:\/\/www.hiro-clinic.or.jp\/dermatology\/wp-content\/uploads\/2025\/03\/28436579_s.jpg 640w, https:\/\/www.hiro-clinic.or.jp\/dermatology\/wp-content\/uploads\/2025\/03\/28436579_s-300x200.jpg 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/figure><\/div>\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>7. \u5fc3\u7406\u30fb\u793e\u4f1a\u7684\u30b5\u30dd\u30fc\u30c8\u3068\u751f\u6d3b\u652f\u63f4<\/strong><\/h2>\n\n\n\n<p>\u60aa\u6027\u9ed2\u8272\u816b\u306e\u8a3a\u65ad\u306f\u3001\u60a3\u8005\u3055\u3093\u3084\u3054\u5bb6\u65cf\u306b\u5927\u304d\u306a\u5fc3\u7406\u7684\u8ca0\u62c5\u3092\u3082\u305f\u3089\u3057\u307e\u3059\u3002\u5c02\u9580\u7684\u306a<strong>\u5fc3\u7406\u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0<\/strong>\u3084<strong>\u30d4\u30a2\u30b5\u30dd\u30fc\u30c8\u56e3\u4f53<\/strong>\u306e\u5229\u7528\u306f\u3001\u6cbb\u7642\u958b\u59cb\u524d\u304b\u3089\u6709\u7528\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u307e\u305f\u3001\u65e5\u5e38\u751f\u6d3b\u3067\u306f\u300c\u7d2b\u5916\u7dda\u5bfe\u7b56\u300d\u300c\u81ea\u5df1\u76ae\u819a\u30c1\u30a7\u30c3\u30af\u306e\u7fd2\u6163\u5316\u300d\u300c\u518d\u767a\u30fb\u8ee2\u79fb\u306e\u5146\u5019\u306e\u6559\u80b2\u300d\u304c\u91cd\u8981\u3002\u7279\u306b\u3054\u5bb6\u65cf\u306b\u3088\u308b\u76ae\u819a\u306e\u89b3\u5bdf\u652f\u63f4\u3084\u3001\u8077\u5834\u3067\u306e\u4f11\u990a\u30fb\u652f\u63f4\u3092\u5f97\u3089\u308c\u308b\u4f53\u5236\u306e\u69cb\u7bc9\u3082\u3001\u6cbb\u7642\u306b\u5411\u304b\u3046\u4e0a\u3067\u5927\u5207\u306a\u57fa\u76e4\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>8.\u6cbb\u7642\u524d\u306b\u6291\u3048\u3066\u304a\u304d\u305f\u3044\u30dd\u30a4\u30f3\u30c8<\/strong><\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>\u30ab\u30c6\u30b4\u30ea<\/strong><\/td><td><strong>\u6291\u3048\u308b\u3079\u304d\u30dd\u30a4\u30f3\u30c8<\/strong><\/td><\/tr><tr><td>\u5b9a\u7fa9\u3068\u5206\u985e<\/td><td>\u60aa\u6027\u9ed2\u8272\u816b\u3068\u306f\u4f55\u304b\u3001\u3069\u3093\u306a\u30bf\u30a4\u30d7\u304c\u3042\u308b\u306e\u304b\u3092\u7406\u89e3<\/td><\/tr><tr><td>\u30ea\u30b9\u30af\u3068\u767a\u75c7\u6a5f\u5e8f<\/td><td>\u7d2b\u5916\u7dda\u3001\u907a\u4f1d\u3001\u514d\u75ab\u72b6\u614b\u306a\u3069\u306e\u57fa\u790e\u3092\u304a\u3055\u3048\u308b<\/td><\/tr><tr><td>\u8a3a\u65ad\u624b\u9806<\/td><td>\u8996\u8a3a \u2192 \u751f\u691c \u2192 \u753b\u50cf\u30fb\u5206\u5b50\u691c\u67fb\u306e\u6d41\u308c<\/td><\/tr><tr><td>\u30b9\u30c6\u30fc\u30b8\u5206\u985e<\/td><td>AJCC\u5206\u985e\u306b\u3088\u308b\u5206\u985e\u3068\u305d\u306e\u610f\u7fa9<\/td><\/tr><tr><td>\u6cbb\u7642\u9078\u629e\u80a2<\/td><td>\u5916\u79d1\u3001\u514d\u75ab\u7642\u6cd5\u3001\u5206\u5b50\u6a19\u7684\u7642\u6cd5\u306a\u3069<\/td><\/tr><tr><td>\u4e88\u5f8c\u3068\u7d4c\u904e\u89b3\u5bdf<\/td><td>\u30b9\u30c6\u30fc\u30b8\u52255\u5e74\u751f\u5b58\u7387\u3001\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u306e\u65b9\u91dd<\/td><\/tr><tr><td>\u5fc3\u7406\u30fb\u751f\u6d3b\u652f\u63f4<\/td><td>\u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0\u3001\u65e5\u5e38\u30b5\u30dd\u30fc\u30c8\u3001\u4e88\u9632\u6559\u80b2\u306a\u3069<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>9. \u6700\u65b0\u306e\u7814\u7a76\u52d5\u5411\u3068\u4eca\u5f8c\u306e\u5c55\u671b<\/strong><\/h2>\n\n\n\n<p>\u8fd1\u5e74\u306e\u60aa\u6027\u9ed2\u8272\u816b\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u306f\u5287\u7684\u306b\u9032\u6b69\u3057\u3066\u304a\u308a\u3001\u7279\u306b<strong>\u514d\u75ab\u7642\u6cd5\u3068\u5206\u5b50\u6a19\u7684\u6cbb\u7642<\/strong>\u306e\u5206\u91ce\u3067\u306f\u65e5\u9032\u6708\u6b69\u306e\u7814\u7a76\u304c\u9032\u3093\u3067\u3044\u307e\u3059\u3002\u3053\u3053\u3067\u306f\u3001\u73fe\u5728\u6ce8\u76ee\u3055\u308c\u3066\u3044\u308b\u81e8\u5e8a\u7814\u7a76\u3084\u3001\u5c06\u6765\u306e\u6cbb\u7642\u6226\u7565\u306e\u65b9\u5411\u6027\u306b\u3064\u3044\u3066\u89e3\u8aac\u3057\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>9-1. \u65b0\u3057\u3044\u514d\u75ab\u7642\u6cd5\u306e\u53ef\u80fd\u6027<\/strong><\/h3>\n\n\n\n<p>\u5f93\u6765\u306e\u6297PD-1\u6297\u4f53\uff08\u30cb\u30dc\u30eb\u30de\u30d6\u306a\u3069\uff09\u3084\u6297CTLA-4\u6297\u4f53\uff08\u30a4\u30d4\u30ea\u30e0\u30de\u30d6\uff09\u306b\u52a0\u3048\u3001**LAG-3\uff08\u30ea\u30f3\u30d1\u7403\u6d3b\u6027\u5316\u907a\u4f1d\u5b503\uff09**\u3092\u6a19\u7684\u3068\u3057\u305f\u65b0\u898f\u514d\u75ab\u30c1\u30a7\u30c3\u30af\u30dd\u30a4\u30f3\u30c8\u963b\u5bb3\u85ac\uff08\u4f8b\uff1arelatlimab\uff09\u304c\u3001\u4f75\u7528\u7642\u6cd5\u3068\u3057\u3066\u81e8\u5e8a\u5fdc\u7528\u3055\u308c\u3066\u3044\u307e\u3059\u3002LAG-3\u306fT\u7d30\u80de\u306e\u75b2\u5f0a\u306b\u95a2\u4e0e\u3059\u308b\u5206\u5b50\u3067\u3042\u308a\u3001PD-1\u3068\u306e\u4f75\u7528\u306b\u3088\u308a\u3055\u3089\u306b\u6cbb\u7642\u52b9\u679c\u3092\u9ad8\u3081\u308b\u3053\u3068\u304c\u671f\u5f85\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u307e\u305f\u3001CAR-T\u7d30\u80de\u7642\u6cd5\u3084\u304c\u3093\u30ef\u30af\u30c1\u30f3\u3001TIL\uff08\u816b\u760d\u6d78\u6f64\u30ea\u30f3\u30d1\u7403\uff09\u7642\u6cd5\u3068\u3044\u3063\u305f<strong>\u500b\u5225\u5316\u514d\u75ab\u7642\u6cd5<\/strong>\u306e\u7814\u7a76\u3082\u9032\u884c\u4e2d\u3067\u3001\u518d\u767a\u30fb\u96e3\u6cbb\u6027\u306e\u60aa\u6027\u9ed2\u8272\u816b\u3078\u306e\u5fdc\u7528\u304c\u671f\u5f85\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>9-2. 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class=\"wp-block-heading\"><strong>9-3. 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