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皮肤黑色素瘤的皮肤镜和反射式共聚焦显微镜特征与BRAF突变状态之间的关联。

Association between dermoscopic and reflectance confocal microscopy features of cutaneous melanoma with BRAF mutational status.

作者信息

Bombonato C, Ribero S, Pozzobon F C, Puig-Butille J A, Badenas C, Carrera C, Malvehy J, Moscarella E, Lallas A, Piana S, Puig S, Argenziano G, Longo C

机构信息

Dermatology and Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy.

Dermatology Department, University of Turin, Turin, Italy.

出版信息

J Eur Acad Dermatol Venereol. 2017 Apr;31(4):643-649. doi: 10.1111/jdv.14028. Epub 2016 Nov 14.

Abstract

BACKGROUND

Melanomas harbouring common genetic mutations might share certain morphological features detectable with dermoscopy and reflectance confocal microscopy. BRAF mutational status is crucial for the management of metastatic melanoma.

OBJECTIVES

To correlate the dermoscopic characteristics of primary cutaneous melanomas with BRAF mutational status. Furthermore, a subset of tumours has also been analysed for the presence of possible confocal features that might be linked with BRAF status.

METHODS

Retrospectively acquired dermoscopic and confocal images of patients with melanoma in tertiary referral academic centres: Skin Cancer Unit in Reggio Emilia and at the Melanoma Unit in Barcelona. Kruskal-Wallis test, logistic regressions, univariate and multivariate analyses have been performed to find dermoscopic and confocal features significantly correlated with BRAF mutational status.

RESULTS

Dermoscopically, the presence of irregular peripheral streaks and ulceration were positive predictors of BRAF-mutated melanomas with a statistically significance value, while dotted vessels were more represented in wild-type melanomas. None of the evaluated reflectance confocal microscopy features were correlated with genetic profiling.

CONCLUSIONS

Ulceration and irregular peripheral streaks represent dermoscopic feature indicative for BRAF-mutated melanoma, while dotted vessels are suggestive for wild-type melanoma.

摘要

背景

携带常见基因突变的黑色素瘤可能具有某些通过皮肤镜和反射式共聚焦显微镜可检测到的形态学特征。BRAF突变状态对于转移性黑色素瘤的治疗至关重要。

目的

将原发性皮肤黑色素瘤的皮肤镜特征与BRAF突变状态相关联。此外,还对一部分肿瘤进行了分析,以寻找可能与BRAF状态相关的共聚焦特征。

方法

回顾性获取在三级转诊学术中心(雷焦艾米利亚的皮肤癌科室和巴塞罗那的黑色素瘤科室)的黑色素瘤患者的皮肤镜和共聚焦图像。进行了Kruskal-Wallis检验、逻辑回归、单变量和多变量分析,以找出与BRAF突变状态显著相关的皮肤镜和共聚焦特征。

结果

在皮肤镜检查中,不规则周边条纹和溃疡的存在是BRAF突变型黑色素瘤的阳性预测指标,具有统计学意义,而点状血管在野生型黑色素瘤中更为常见。所评估的反射式共聚焦显微镜特征均与基因谱分析无关。

结论

溃疡和不规则周边条纹是BRAF突变型黑色素瘤的皮肤镜特征,而点状血管提示野生型黑色素瘤。

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