Cartron A M, Aldana P C, Khachemoune A
Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Veterans Affairs Medical Center, Brooklyn, NY, USA.
Clin Exp Dermatol. 2021 Jan;46(1):28-33. doi: 10.1111/ced.14328. Epub 2020 Jun 29.
Regression is an important histopathological parameter reported for the diagnosis of primary cutaneous melanoma. Histological regression is defined by The College of American Pathologists as the replacement of tumour cells by lymphocytic inflammation, with attenuation of the epidermis, and nonlaminated dermal fibrosis with inflammatory cells, melanophagocytosis and telangiectasia. Histological regression may be reported as absent versus present and, if present, as complete, partial or segmental. The stages of histological regression are early, intermediate and late, depending on the extent of histological inflammation and fibrosis. Regression occurs when the host's immune system attacks primary melanocytic tumour cells via tumour-infiltrating lymphocytes, resulting in fibrosis. The immunological mechanisms driving complete, partial and segmental regression may vary. In this first part of this two-part review, we review the history, histological criteria and pathogenesis of regression in primary cutaneous melanoma, while in Part 2 we will review the effect of histological regression on prognosis, evaluation and management.
消退是报道用于原发性皮肤黑色素瘤诊断的一项重要组织病理学参数。美国病理学家学会将组织学消退定义为肿瘤细胞被淋巴细胞炎症替代，伴有表皮变薄，以及有炎症细胞、噬黑素细胞和毛细血管扩张的非层状真皮纤维化。组织学消退可报告为无或有，若有，则报告为完全、部分或节段性。根据组织学炎症和纤维化的程度，组织学消退的阶段分为早期、中期和晚期。当宿主免疫系统通过肿瘤浸润淋巴细胞攻击原发性黑素细胞肿瘤细胞时，就会发生消退，从而导致纤维化。驱动完全、部分和节段性消退的免疫机制可能有所不同。在这篇分为两部分的综述的第一部分中，我们回顾了原发性皮肤黑色素瘤消退的历史、组织学标准和发病机制，而在第二部分中，我们将回顾组织学消退对预后、评估和管理的影响。
