Silverman M K, Golomb F M, Kopf A W, Grin-Jorgensen C M, Vossaert K A, Doyle J P, Levenstein M J
Melanoma Cooperative Group, New York University Medical Center, New York.
J Am Acad Dermatol. 1992 Aug;27(2 Pt 1):214-9. doi: 10.1016/0190-9622(92)70173-d.
Recently our group reported on the shrinkage of 199 malignant melanoma surgical-excision specimens. In that report, a multivariate analysis revealed that the age of the patient was the only factor that significantly affected the percentage shrinkage of a surgical specimen. In addition, a formula was presented that extrapolates the actual surgical margins (in vivo) from the (contracted) fixed-tissue pathology report measurement and the reported in vivo lesion diameter.
The goals of this study are to verify that shrinkage of surgical specimens is approximately 20% and that the margin formula can be successfully applied to a different group of patients.
Four hundred seven patients with malignant melanoma were prospectively enrolled to measure preexcision (outlined with ink) surgical margins, fixed-tissue (contracted) surgical margins, and overall specimen shrinkage.
It is verified that overall shrinkage of cutaneous surgical specimens is approximately 20%. Surgical specimens from patients younger than 50 years of age have approximately 25% shrinkage. Those specimens from patients 50 to 59 years of age have approximately 20% shrinkage and those from patients 60 years of age or older have about 15% shrinkage. The surgical margins predicted by the margin formula were within +/- 3.5 mm of the actual measured surgical margin 86.5% of the time.
The actual surgical margins (in vivo) of a malignant melanoma can be reasonably estimated from the fixed-tissue pathology measurement via the margin formula. The shrinkage of a surgical specimen is 15% to 25% depending on the patient's age.
最近我们小组报告了199例恶性黑色素瘤手术切除标本的收缩情况。在该报告中，多变量分析显示患者年龄是唯一显著影响手术标本收缩百分比的因素。此外，还提出了一个公式，可根据（收缩后的）固定组织病理报告测量值和报告的体内病变直径推断实际手术切缘（体内）。
本研究的目的是验证手术标本的收缩率约为20%，以及切缘公式能否成功应用于另一组患者。
前瞻性纳入407例恶性黑色素瘤患者，测量切除前（用墨水勾勒）手术切缘、固定组织（收缩后）手术切缘和标本总体收缩情况。
证实皮肤手术标本的总体收缩率约为20%。年龄小于50岁患者的手术标本收缩率约为25%。50至59岁患者的标本收缩率约为20%，60岁及以上患者的标本收缩率约为15%。切缘公式预测的手术切缘在86.5%的时间内与实际测量的手术切缘相差±3.5毫米以内。
通过切缘公式，可根据固定组织病理测量合理估计恶性黑色素瘤的实际手术切缘（体内）。手术标本的收缩率为15%至25%，具体取决于患者年龄。
