Cosgarea Ioana, Griewank Klaus G, Ungureanu Loredana, Tamayo Arturo, Siepmann Timo
Department of Dermatology, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany.
Front Oncol. 2020 May 20;10:837. doi: 10.3389/fonc.2020.00837. eCollection 2020.
Deep penetrating nevi (DPN) are rare melanocytic nevi, which can exhibit atypical histological features hampering the differentiation from malignant melanoma. DPN are considered benign melanocytic lesions, but rare spread to lymph nodes and unfavorable clinical outcomes associated with borderline/atypical DPN (B-DPN) has been reported. Since no guidelines are available for DPN and B-DPN, we aimed to review the literature on DPN and B-DPN to assess the management and prognosis. We screened 3,513 references from EMBASE, Scopus and Medline databases, and included 15 studies with a total of 355 DPN patients and 48 B-DPN patients. Therapeutic interventions ranged from simple excision to wide excisions and sentinel lymph node biopsy (SLNB), with block lymph node dissection in some positive SLNB cases. Follow-up periods ranged from 3 months to 23 years during which a total of five recurrences, two in DPN and three in B-DPN group, and three metastases, in B-DPN group, were reported. While some of the included studies comprised clinical and histopathological correlation, few included genetic assessment. The present review highlights the need for prospective cohort studies applying composite measures to identify effective regimens of diagnostic workup and treatment in DPN and B-DPN.
深部浸润性痣（DPN）是罕见的黑素细胞痣，可表现出非典型组织学特征，妨碍与恶性黑色素瘤的鉴别。DPN被认为是良性黑素细胞病变，但有报道称其罕见转移至淋巴结，且与边缘性/非典型DPN（B-DPN）相关的临床结局不佳。由于目前尚无针对DPN和B-DPN的指南，我们旨在回顾关于DPN和B-DPN的文献，以评估其管理和预后。我们从EMBASE、Scopus和Medline数据库中筛选了3513篇参考文献，纳入了15项研究，共355例DPN患者和48例B-DPN患者。治疗干预措施包括单纯切除、广泛切除和前哨淋巴结活检（SLNB），部分SLNB阳性病例行区域淋巴结清扫。随访时间为3个月至23年，期间共报告5例复发，其中DPN组2例，B-DPN组3例，B-DPN组有3例转移。虽然部分纳入研究包含临床和组织病理学相关性，但很少有研究进行基因评估。本综述强调需要开展前瞻性队列研究，采用综合措施来确定DPN和B-DPN诊断检查和治疗的有效方案。
