Larson Allison R, Rothschild Brian, Walls Andrew C, Granter Scott R, Qureshi Abrar A, Murphy George F, Laga Alvaro C
Division of Dermatopathology, Department of Pathology, Brigham and Women's, Hospital, Harvard Medical School, Boston, MA, USA.
Department of Dermatology, Boston Medical Center, Boston, MA, USA.
J Cutan Pathol. 2015 Aug;42(8):536-41. doi: 10.1111/cup.12517. Epub 2015 May 26.
In 2009 the revised seventh staging system for melanoma recommended the use of mitotic count to separate stage T1a from T1b. However, careful scrutiny of cases may lead to an inadvertent selection effect, with consequent increased reporting of mitotic counts.
We investigated whether there is a significant increase in mitotic counts reported since 2009 for melanomas with a Breslow thickness of 1.0 mm or less. We conducted a retrospective, case-controlled study examining invasive melanoma cases at a large academic center. Mitotic counts were compared between pathology reports before 2009 (n = 61) and after 2009 (n = 125), with a subset of slides re-examined in a blinded fashion.
Before the 2009 staging guidelines, 51% of cases had one or more mitosis reported compared to 38% after 2009 (p = 0.113). Blinded re-counting did not yield a significant difference when compared with the original pathology reports in either group.
There was not a significant difference in the number of mitoses reported after the implementation of the new guidelines.
2009年黑色素瘤修订后的第七版分期系统建议使用有丝分裂计数来区分T1a期和T1b期。然而，对病例的仔细审查可能会导致一种无意的选择效应，从而增加有丝分裂计数的报告。
我们调查了自2009年以来，Breslow厚度为1.0毫米或更小的黑色素瘤报告的有丝分裂计数是否有显著增加。我们在一个大型学术中心进行了一项回顾性病例对照研究，检查侵袭性黑色素瘤病例。比较了2009年之前（n = 61）和2009年之后（n = 125）的病理报告中的有丝分裂计数，并以盲法重新检查了一部分切片。
在2009年分期指南之前，51%的病例报告有一个或多个有丝分裂，而2009年之后为38%（p = 0.113）。与两组中的原始病理报告相比，盲法重新计数没有产生显著差异。
新指南实施后报告的有丝分裂数量没有显著差异。
