Balkau D, Gartmann H, Wischer W, Grootens A, Hagemeier H H, Hundeiker M, Suter L
Fachklinik Hornheide, University of Münster, FRG.
Dermatologica. 1988;177(3):129-37. doi: 10.1159/000248530.
According to the quantity of single atypical melanocytes at the dermoepidermal junction 334 nevi were assigned to 3 groups: (1) with pronounced nuclear and cellular atypia (n = 73); (2) with moderate atypia (n = 127), and (3) without atypical melanocytes (n = 134). Three architectural features were almost exclusively observed in groups 1 and 2 with cellular and nuclear atypia: atypical localization of melanocytes in the epidermis, irregular distribution of melanocytes in the junctional zone and atypical nests of melanocytes. A combination of 2 or 3 of these features was seen in 76% of the nevi with pronounced cellular and nuclear atypia, in 28% of those with moderate atypia and in none of those without atypical melanocytes. Regarding 4 other criteria only minor but still statistically significant differences were found between the 3 groups of nevi. We conclude that these 4 other criteria, i.e. inflammatory infiltrate, lamellar and/or concentric fibroplasia, persisting lentiginous hyperplasia and dust-like pigment in melanocytes and nevus cells are not helpful for the diagnosis of a dysplastic nevus because of their low specificity. Minimal requirements for the diagnosis of a dysplastic nevus are suggested.
根据真皮表皮交界处单个非典型黑素细胞的数量，334个痣被分为3组：（1）具有明显核和细胞异型性（n = 73）；（2）具有中度异型性（n = 127），以及（3）无非典型黑素细胞（n = 134）。在有细胞和核异型性的第1组和第2组中几乎仅观察到三种结构特征：黑素细胞在表皮中的非典型定位、交界区黑素细胞的不规则分布以及黑素细胞的非典型巢。在76%具有明显细胞和核异型性的痣、28%具有中度异型性的痣以及无非典型黑素细胞的痣中均未见到这些特征中的2种或3种特征的组合。关于其他4项标准，在这3组痣之间仅发现了微小但仍具有统计学意义的差异。我们得出结论，这其他4项标准，即炎症浸润、板层状和/或同心性纤维组织增生、持续的雀斑样增生以及黑素细胞和痣细胞中的尘样色素，因其特异性低，对发育异常痣的诊断无帮助。本文提出了发育异常痣诊断的最低要求。
