Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA.
Veterans Affairs Medical Center, Brooklyn, NY, USA.
Clin Exp Dermatol. 2020 Oct;45(7):818-823. doi: 10.1111/ced.14329. Epub 2020 Jul 13.
The effect of histological regression on patient prognosis for primary cutaneous melanoma is controversial. Some authors hypothesize that regression indicates a robust systemic immune response and may decrease risk of metastasis. Others argue that histological regression calls into question a T0 diagnosis because there may have been an invasive component of the melanoma that is no longer visible but is still active. The literature to date does not suggest that histological regression is associated with increased risk of positive sentinel lymph node status, metastasis or increased risk of mortality. Thus, the presence of histological regression should not change patient staging, evaluation or management. The criteria used for reporting regression have varied dramatically across studies, and standardized reporting is needed to foster evidence-based practices in the future.
组织学消退对原发性皮肤黑色素瘤患者预后的影响存在争议。一些作者假设消退表明了强大的全身免疫反应，可能降低转移风险。另一些人则认为，组织学消退对 T0 期诊断提出了质疑，因为黑色素瘤可能存在已不再可见但仍活跃的侵袭性成分。迄今为止，文献并未表明组织学消退与前哨淋巴结状态阳性、转移或死亡率增加的风险增加相关。因此，组织学消退的存在不应改变患者的分期、评估或治疗。在不同的研究中，用于报告消退的标准差异很大，需要进行标准化报告，以促进未来基于证据的实践。
