Podolec Katarzyna, Bronikowska Agnieszka, Pirowska Magdalena, Wojas-Pelc Anna
Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland.
Postepy Dermatol Alergol. 2020 Oct;37(5):677-684. doi: 10.5114/ada.2019.83221. Epub 2019 Mar 4.
Due to the rising incidence of cutaneous melanoma there is a great need for the development of new diagnostic techniques as well as the improvement of those that are already well known, such as dermoscopy. Since early detection and a proper technique for excising the tumor are crucial for patients' survival, early staging of the tumor is very important.
To investigate whether there is a significant difference between the presence of selected dermoscopic features compared to the location on the skin and pathology results: Breslow's depth, mitotic index and ulceration.
We examined videodermoscopic images of cutaneous melanomas in 81 patients and compared their features with the histological results such as Breslow's depth, mitotic index and ulceration. In the study, we divided and compared the tumors in groups: and invasive, ≤ 1.0 mm and > 1.0 mm thick on the Breslow scale.
In the study we observed statistically significantly higher prevalence of pseudopods (30.5%) and multicomponent pattern (69.5%) in invasive melanomas in comparison to in situ melanomas (9.1% and 36.4% respectively). White regression structures were more commonly described in invasive melanomas thicker than 1.0 mm on Breslow's scale. Atypical blood vessels and nodules were more specific to invasive melanomas with ulcerations and mitotic index ≥ 1. The atypical pigment network was more specific for thin invasive melanomas.
Presence of pseudopods, a multicomponent pattern, white regression structures, atypical blood vessels and nodules on dermoscopy suggest invasive (high stage) melanoma.
由于皮肤黑色素瘤的发病率不断上升,迫切需要开发新的诊断技术,并改进那些已广为人知的技术,如皮肤镜检查。由于早期检测和正确的肿瘤切除技术对患者的生存至关重要,因此肿瘤的早期分期非常重要。
研究与皮肤部位及病理结果(Breslow深度、有丝分裂指数和溃疡形成)相比,所选皮肤镜特征的存在是否存在显著差异。
我们检查了81例患者皮肤黑色素瘤的视频皮肤镜图像,并将其特征与组织学结果(如Breslow深度、有丝分裂指数和溃疡形成)进行了比较。在研究中,我们将肿瘤按Breslow分级分为原位和侵袭性、厚度≤1.0mm和>1.0mm的组并进行比较。
在研究中,我们观察到与原位黑色素瘤(分别为9.1%和36.4%)相比,侵袭性黑色素瘤中假足(30.5%)和多成分模式(69.5%)的发生率在统计学上显著更高。在Breslow分级中,厚度大于1.0mm的侵袭性黑色素瘤中更常出现白色消退结构。非典型血管和结节在有溃疡形成且有丝分裂指数≥1的侵袭性黑色素瘤中更具特异性。非典型色素网络在薄的侵袭性黑色素瘤中更具特异性。
皮肤镜检查中假足、多成分模式、白色消退结构、非典型血管和结节的存在提示侵袭性(高分期)黑色素瘤。