Iyer J G, Koba S, Nghiem P
Dermatology Division, University of Washington, Seattle, Washington, USA.
Actas Dermosifiliogr. 2009 Dec;100 Suppl 2(Suppl 2):49-54. doi: 10.1016/s0001-7310(09)73378-2.
Merkel cell carcinoma (MCC) is a neuroendocrine skin cancer with a higher propensity for recurrence and metastasis than melanoma or squamous cell carcinoma. Despite aggressive behavior and the tripling of its reported incidence in the past 20 years, there is extensive confusion about how MCC should be managed. Here we address two issues that have impeded optimal MCC management: lack of a consensus staging system and lack of unique diagnostic codes for MCC. Five conflicting systems currently used to stage MCC will be replaced by one system in 2010 that will diminish confusion about prognosis and management among physicians and patients. The diagnostic bundling of MCC with numerous less aggressive skin cancers leads to care refusals by insurance and an inability to track MCC care costs. Worldwide adoption in 2009 of specific diagnostic codes for MCC will also improve understanding and management of this often-lethal skin cancer.
默克尔细胞癌（MCC）是一种神经内分泌性皮肤癌，与黑色素瘤或鳞状细胞癌相比，其复发和转移倾向更高。尽管MCC具有侵袭性，且在过去20年中报告的发病率增长了两倍，但对于如何治疗MCC仍存在广泛的困惑。在此，我们探讨两个阻碍MCC最佳治疗的问题：缺乏共识性的分期系统以及缺乏MCC的独特诊断编码。目前用于MCC分期的五个相互冲突的系统将于2010年被一个系统所取代，这将减少医生和患者对预后和治疗的困惑。MCC与许多侵袭性较低的皮肤癌进行诊断捆绑，导致保险拒绝承保，并无法跟踪MCC的治疗费用。2009年在全球范围内采用MCC的特定诊断编码，也将改善对这种往往致命的皮肤癌的理解和治疗。
