Barnhill Raymond L, Piepkorn Michael W, Duncan Lyn M, Knezevich Stevan, Elmore Joann G, Elder David E
Department of Translational Research, Institut Curie, UFR of Medicine University of Paris Cité, Paris, France.
Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
Clin Dermatol. 2025 May-Jun;43(3):306-314. doi: 10.1016/j.clindermatol.2024.09.007. Epub 2024 Sep 10.
The new revised MPATH-Dx (version 2.0) reporting schema for melanocytic lesions is presented. Principal changes include the simplification of the previous five-class version 1.0 to a four-class hierarchy of melanocytic lesions to improve diagnostic agreement and to provide more explicit guidance for the management of patients. Version 2.0 also has clearly defined histopathologic criteria for classification of class I and II lesions, which are now designated as low-grade (mild-to-moderate) atypia and high-grade (high-end moderate-to-severe) atypia, respectively. This new revised schema also includes specific provisions for the less common World Health Organization pathways to melanoma, provides guidance for classifying "intermediate" class II tumors (melanocytomas), and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as a neoplasm falling short of fully evolved melanoma.
本文介绍了用于黑素细胞性病变的新修订的MPATH-Dx（2.0版）报告模式。主要变化包括将先前的五级1.0版简化为黑素细胞性病变的四级分级体系，以提高诊断一致性，并为患者管理提供更明确的指导。2.0版还为I类和II类病变的分类明确了组织病理学标准，现在分别指定为低级别（轻度至中度）异型性和高级别（高端中度至重度）异型性。这个新修订的模式还包括针对世界卫生组织定义的较少见的黑素瘤发展途径的具体规定，为“中间型”II类肿瘤（黑素细胞瘤）的分类提供指导，并识别出具有极低风险且最终可能重新分类为未完全发展为黑素瘤的肿瘤的pT1a黑素瘤子集。
