薄型黑色素瘤最新进展：国际研讨会成果

Update on Thin Melanoma: Outcome of an International Workshop.

作者信息

Mihic-Probst Daniela, Shea Chris, Duncan Lyn, de la Fouchardiere Arnaud, Landman Gilles, Landsberg Jennifer, ven den Oord Joost, Lowe Lori, Cook Martin G, Yun Sook Jung, Clarke Loren, Messina Jane, Elder David E, Barnhill Raymond L

机构信息

*Department of Surgical Pathology, University Hospital Zürich, Zürich, Switzerland †Department of Dermatology, University of Chicago, IL ‡Dermatopathology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA **Departments of Dermatology and Pathology, University of Michigan, Ann Arbor, MI §§Myriad Genetic Laboratories Inc., Salt Lake City, UT ∥∥Departments of Pathology and Cell Biology and Dermatology, University of South Florida Morsani College of Medicine, Tampa, FL ¶¶Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, PA §Departement de Biopathologie, Centre Léon Bérard, Lyon ##Department of Pathology, Institut Curie, Paris, France ∥Escola Paulista de Medicina, Universidade de São Paulo, Brasil ¶Department of Molecular Immunology and Cell Biology, Life and Medical Sciences Institute, University of Bonn, Germany #Laboratory of Translational Cell and Tissue Research and University Hospitals, University of Leuven, KUL, Leuven, Belgium ††Department of Molecular Oncology, CRUK Manchester Institute Royal Surrey County Hospital, Guildford, UK ‡‡Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Adv Anat Pathol. 2016 Jan;23(1):24-9. doi: 10.1097/PAP.0000000000000100.

DOI:10.1097/PAP.0000000000000100

PMID:26645459

Abstract

The following communication summarizes the proceedings of a 1-day Workshop of the International Melanoma Pathology Study Group, which was devoted to thin melanoma. The definitions and histologic criteria for thin melanoma were reviewed. The principal differential diagnostic problems mentioned included the distinction of thin melanoma from nevi, especially from nevi of special site, irritated nevi, inflamed and regressing nevi, and dysplastic nevi. Histologic criteria for this analysis were discussed and the importance of clinico-pathologic correlation, especially in acral sites, was emphasized. Criteria for the minimal definition of invasion were also discussed. In addition, a new technique of m-RNA expression profiling with 14 genes was presented and facilitated the distinction of thin melanomas from nevus in histologically obvious cases. However, for particular nevi, it was not obvious why the results indicated a malignant lesion. Despite many molecular and other ancillary investigations, Breslow thickness remains the most important prognostic factor in thin melanoma. The prognostic significance of radial (horizontal) and vertical growth phases, Clark level, regression, and mitotic rate were also discussed. Because of the increasing frequency of thin melanomas, there is a great need to develop more refined predictors of thin melanomas with worse clinical outcome.

摘要

以下通讯总结了国际黑色素瘤病理研究小组为期一天的研讨会的会议记录，该研讨会专门讨论薄型黑色素瘤。回顾了薄型黑色素瘤的定义和组织学标准。提到的主要鉴别诊断问题包括薄型黑色素瘤与痣的区分，特别是与特殊部位的痣、受刺激的痣、炎症性和消退性痣以及发育异常痣的区分。讨论了该分析的组织学标准，并强调了临床病理相关性的重要性，尤其是在肢端部位。还讨论了侵袭的最小定义标准。此外，还介绍了一种利用14个基因进行mRNA表达谱分析的新技术，该技术有助于在组织学表现明显的病例中区分薄型黑色素瘤与痣。然而，对于某些特定的痣，结果为何表明为恶性病变并不明显。尽管进行了许多分子和其他辅助检查，但Breslow厚度仍然是薄型黑色素瘤最重要的预后因素。还讨论了放射状（水平）和垂直生长阶段、Clark分级、消退和有丝分裂率的预后意义。由于薄型黑色素瘤的发病率不断增加，迫切需要开发更精确的预测指标，以预测临床结果较差的薄型黑色素瘤。