Concordance Between a Mohs Micrographic Surgeon and Dermatopathologist on Margin Status for Melanoma In Situ and the Role of Immunohistochemical Stains.

IF 2.5 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2025-05-23 DOI:10.1097/DSS.0000000000004673

Arianna F Yanes, Amina Bougrine, Adriano Piris, Emily S Ruiz, Abigail Waldman

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Abstract

Background: Few studies have examined the concordance between Mohs surgeons and dermatopathologists' interpretation of margin status during Mohs micrographic surgery (MMS) for melanoma in situ (MIS).

Objective: The objectives of this study were to determine the concordance between a Mohs surgeon and dermatopathologist on margin status for MIS and to analyze the role of immunohistochemical stains during Mohs surgery.

Materials and methods: This was a prospective study at 1 academic center of patients undergoing Mohs surgery for MIS. The Mohs surgeon and dermatopathologist independently examined the margins and completed surveys on the usefulness of H&E and immunohistochemical stains in each case. Six-year follow-up data on tumor recurrence and metastasis were collected.

Results: The surgeon and dermatopathologist agreed on margin status in 95% of cases (95% confidence interval: 0.84-0.99). The dermatopathologist found H&E alone to be the most useful stain for the first stage of MMS, while the Mohs surgeon found the combination of H&E and SOX10 most useful. This study is limited by the use of only 2 physicians.

Conclusion: There was a high concordance between the Mohs surgeon and dermatopathologist on MIS margin status. Immunohistochemical stains were more useful for the Mohs surgeon.

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莫氏显微摄影外科医生和皮肤病理学家对原位黑色素瘤边缘状态的一致性和免疫组织化学染色的作用。

背景：很少有研究检查Mohs外科医生和皮肤病理学家在Mohs显微摄影手术（MMS）治疗原位黑色素瘤（MIS）时对切缘状态的解释之间的一致性。目的：本研究的目的是确定Mohs外科医生和皮肤病理学家对MIS边缘状态的一致性，并分析免疫组织化学染色在Mohs手术中的作用。材料和方法：本研究是在1个学术中心进行的一项前瞻性研究，患者接受莫氏手术治疗MIS。Mohs外科医生和皮肤病理学家独立检查了每个病例的边缘，并完成了H&E和免疫组织化学染色的有效性调查。收集肿瘤复发和转移的6年随访数据。结果：在95%的病例中，外科医生和皮肤病理学家对切缘状态的看法是一致的（95%置信区间：0.84-0.99）。皮肤病理学家发现H&E单独是MMS第一阶段最有用的染色剂，而Mohs外科医生发现H&E和SOX10联合使用最有用。本研究受限于仅使用了2名医生。结论：Mohs外科医生和皮肤病理学家对MIS边缘状态的诊断高度一致。免疫组织化学染色对莫氏外科医生更有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.