Longo Caterina, Piana Simonetta, Lallas Aimilios, Moscarella Elvira, Lombardi Mara, Raucci Margherita, Pellacani Giovanni, Argenziano Giuseppe
Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
PLoS One. 2015 Sep 1;10(9):e0136031. doi: 10.1371/journal.pone.0136031. eCollection 2015.
Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice.
In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center.
Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.
In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.
多项研究已证明整合临床信息与病理信息对于获得黑素细胞肿瘤的确切诊断具有益处。然而,所有这些研究均为回顾性研究,目前尚无关于临床病理相关方法在日常临床实践中作用的数据。
在我们的研究中,我们评估了在一家三级转诊中心对3年内所见的疑难皮肤肿瘤采用常规临床病理相关方法的影响。
有趣的是,在2015例切除病变中,有158例(7.7%)因缺乏临床病理相关性而需要重新评估。值得注意的是,其中0.6%(2045例中的13例)根据临床信息对最初的组织学诊断进行了修订,这些临床信息帮助病理学家重新评估了本身可能平淡或不明显的组织病理学发现。
总之,我们的研究表明,临床医生和病理学家参与的综合方法可通过从单纯以疾病为中心的管理(黑色素瘤与痣)转向以患者为中心的方法来改善特定患者的管理。