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痣相关黑色素瘤的皮肤镜检查

Dermoscopy of Naevus-associated Melanomas.

作者信息

Shitara Danielle, Nascimento Mauricio, Ishioka Priscila, Carrera Cristina, Alós Llúcia, Malvehy Josep, Puig Susana

机构信息

Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain.

出版信息

Acta Derm Venereol. 2015 Jul;95(6):671-5. doi: 10.2340/00015555-2009.

Abstract

In order to determine dermoscopic parameters, a case-control test set of naevus-associated melanomas vs de novo melanomas paired by Breslow thickness and histopathological subtype was analysed by 2 blinded experienced dermoscopists, according to presence of naevus, pattern analysis and ABCD dermoscopy score. The ability to identify naevus-associated melanomas by pattern analysis was low for both blinded dermoscopists (κ < 0.2). Dermoscopy features associated with naevus-associated melanomas were: presence of negative pigment network (OR 9.915, CI 95% 2.182-45.049), globules (OR 2.383, CI 95% 1.15-4.95) and streaks (OR 2.439, CI 95% 1.271-4.680). In contrast, the presence of blue-white veil was related to absence of associated naevus (OR 0.520, CI 95% 0.273-0.991). With the results obtained, 2 different algorithms were proposed. The use of the proposed algorithms could help raise awareness of naevus-associated melanomas and avoid the possibility of incorrectly diagnosing a naevus-associated melanoma if partial biopsies are performed.

摘要

为了确定皮肤镜参数,由两名经验丰富的皮肤镜医生对一组按 Breslow 厚度和组织病理学亚型配对的痣相关黑色素瘤与新发黑色素瘤的病例对照测试集进行分析,根据痣的存在情况、模式分析和 ABCD 皮肤镜评分进行判断。两名皮肤镜医生通过模式分析识别痣相关黑色素瘤的能力均较低(κ<0.2)。与痣相关黑色素瘤相关的皮肤镜特征包括:存在负性色素网络(比值比 9.915,95%置信区间 2.182 - 45.049)、小球(比值比 2.383,95%置信区间 1.15 - 4.95)和条纹(比值比 2.439,95%置信区间 1.271 - 4.680)。相比之下,蓝白色幕的存在与无相关痣有关(比值比 0.520,95%置信区间 0.273 - 0.991)。根据所得结果,提出了两种不同的算法。使用所提出的算法有助于提高对痣相关黑色素瘤的认识,并避免在进行部分活检时错误诊断痣相关黑色素瘤的可能性。

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