Busam K J
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Am J Clin Pathol. 2001 May;115(5):743-6. doi: 10.1309/G7PB-N0P1-BMA8-NFP7.
For the T classification of primary cutaneous melanoma, the current American Joint Committee on Cancer staging (AJCC) system relies on tumor thickness and level of invasion. A new T classification has been proposed based on thickness and ulceration. The slides and reports of 135 departmental pathology consultations of patients referred to a major cancer center with a diagnosis of primary cutaneous invasive malignant melanoma were examined. Whether the outside pathology reports contained information on tumor thickness, level of invasion, and ulceration was recorded. Dermatopathologists had issued 76.3% of the reports and general surgical pathologists, 24.3%. Information provided was as follows: tumor thickness, 97.8%; Clark level, 71.9%; and presence or absence of ulceration, 28.1%. Of the 97 melanomas with no comment on ulceration, 17 were indeed ulcerated. Thus, the lack of a comment on ulceration cannot be equated with the absence of ulceration. The present study documents that many pathology reports on melanomas lack sufficient information for AJCC staging. Therefore, review of outside pathology material is necessary not only to confirm or revise the tumor diagnosis but also to provide clinicians with histologic parameters required for AJCC staging.
对于原发性皮肤黑色素瘤的T分类，当前美国癌症联合委员会（AJCC）分期系统依赖于肿瘤厚度和浸润水平。基于厚度和溃疡情况提出了一种新的T分类。对转诊至一家大型癌症中心、诊断为原发性皮肤浸润性恶性黑色素瘤的患者的135份科室病理会诊切片及报告进行了检查。记录外部病理报告是否包含肿瘤厚度、浸润水平和溃疡情况的信息。皮肤科病理学家出具了76.3%的报告，普通外科病理学家出具了24.3%的报告。提供的信息如下：肿瘤厚度，97.8%；克拉克分级，71.9%；以及有无溃疡，28.1%。在97例未提及溃疡情况的黑色素瘤中，17例实际上存在溃疡。因此，未提及溃疡情况不能等同于不存在溃疡。本研究证明，许多黑色素瘤的病理报告缺乏足够信息用于AJCC分期。因此，审查外部病理材料不仅对于确认或修正肿瘤诊断是必要的，而且对于为临床医生提供AJCC分期所需的组织学参数也是必要的。
