University of Maryland School of Medicine, Baltimore, MD, USA.
Veterans Affairs Medical Center, Brooklyn, NY, USA.
Arch Dermatol Res. 2021 Mar;313(2):65-69. doi: 10.1007/s00403-020-02106-w. Epub 2020 Jul 6.
Melanoma in situ (MIS) is a form of radial growth phase melanoma in which the proliferation of malignant cells is confined to the epidermis. Histologic features are invaluable in recognition of MIS. Regression occurs when the host's immune system attacks the primary melanocytic tumor cells via tumor infiltrate lymphocytes, resulting in a fibrotic component. Various criteria have been proposed to assess the extent of histologic regression. Some authors define regression based on histologic features of the dermis, which is inappropriate for MIS. Specific dermatoscopic findings of regression in MIS have been reported including peppering, grey-blue areas, white areas, and blue-whitish veils. Many studies assess the impact of histologic regression on invasive melanoma prognosis, but no studies to-date have considered the effect of histologic regression exclusively in patients with MIS. The literature to-date does not suggest evaluation and management should be modified if histologic regression is present in MIS. Studies specifically investigating the effect of histologic regression on MIS prognosis are needed to inform evidence-based practices.
原位黑色素瘤（MIS）是一种放射状生长阶段的黑色素瘤，其恶性细胞的增殖局限于表皮。组织学特征对于识别 MIS 非常有价值。当宿主的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，就会发生退化，导致纤维成分。已经提出了各种标准来评估组织学退化的程度。一些作者根据真皮的组织学特征定义退化，这对于 MIS 是不适当的。MIS 中已经报道了一些特定的组织学退化的皮肤镜发现，包括胡椒状、灰蓝色区域、白色区域和蓝白色面纱。许多研究评估组织学退化对侵袭性黑色素瘤预后的影响，但迄今为止尚无研究专门考虑组织学退化对 MIS 患者的影响。迄今为止的文献并没有表明，如果 MIS 中存在组织学退化，就应该修改评估和管理。需要进行专门研究组织学退化对 MIS 预后影响的研究，以提供循证实践的依据。
