Witkowski Alexander, Jarell Abel D, Ahmed Kelli L, Siegel Jennifer J, Russell Brooke H, Rogers Jason H, Goldberg Matthew S, Fernandes Neil F, Ludzik Joanna, Farberg Aaron S
Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.
Granite State Dermatology, PC, Portsmouth, NH, USA.
Melanoma Manag. 2024 May 9;11(1):MMT68. doi: 10.2217/mmt-2023-0002. eCollection 2024.
Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.
具有诊断和/或临床不确定性的皮肤黑素细胞肿瘤给患者管理带来了挑战。描述了六个具有诊断/临床不确定性的随机病例场景，同时给出或未给出良性或恶性诊断基因表达谱（GEP）结果。通过报告相对于基线标准化的管理变化的平均增加/减少来评估临床影响（n = 32名皮肤科医生）。良性GEP结果促使临床医生减小手术切缘（84.2%）。恶性GEP结果使手术切除建议升级（100%）。对于良性或恶性GEP结果，大多数（72.2%）减少了随访频率，几乎所有（98.9%）增加了随访频率。GEP结果总体上提高了管理计划的信心。诊断性GEP检测有助于在各种诊断不明确或临床病理不一致的情况下指导临床决策。
