基因组分析有助于皮肤镜下非典型色素病变的治疗。

IF 1.5 4区 医学 Q3 DERMATOLOGY
Gary L Peck, Samantha R Johnson, Sarah W Matthews, Burkhard Jansen, Loren E Clarke, Rachel A Reifer, Maral Kibarian Skelsey
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引用次数: 0

摘要

背景:在浸润性黑色素瘤中发现了许多黑色素瘤特有的皮肤镜特征,而在原位黑色素瘤(MIS)和非典型痣(ATN)中发现的特征较少。关于哪些特征是区分MIS和ATN的关键,尚未达成共识。目的:确定1)是否有皮肤镜特征可区分早期MIS和ATN;2)基因组生物标志物(LINC00518和PRAME)的非侵入性评估是否有助于患者管理:从2018年到2023年,对56例黑色素瘤的5个临床特征和13个皮肤镜特征以及黑色素瘤相关基因组生物标志物进行了评估。随机抽取基因组生物标志物阳性和阴性的两组ATN进行对比:结果:本研究中的所有黑色素瘤都表达了一种或两种黑色素瘤相关基因组标记物。在 13 个皮肤镜特征中,MIS 平均有 3.90 个特征(范围为 2-7),而侵袭性黑色素瘤平均有 4.44 个特征(范围为 3-6)。40个MIS黑色素瘤中有16个(40%)和16个浸润性黑色素瘤中有3个(18.8%)具有3个或更少的皮肤镜特征。这些结果与在两组ATN中观察到的结果相当。最常见的皮肤镜特征是色素网缺失或减少、回归结构和颗粒度。这些特征的结合最有助于确定需要进行基因组检测的病变:结论:仅凭临床和皮肤镜特征无法区分 MIS 和 ATN。无创基因组检测有助于区分低风险和高风险病变,并有助于临床管理决策。基因组检测对有大量皮损的患者尤其有帮助,根据临床和皮肤镜检查,有几个皮损被考虑进行活检。J Drugs Dermatol.2024;23(9):717-723. doi:10.36849/JDD.8454.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Genomic Analysis Aids in the Management of Dermoscopically Atypical Pigmented Lesions.

Background: Numerous melanoma-specific dermoscopic features have been described in invasive melanomas, while fewer features are found in melanoma in situ (MIS) and atypical nevi (ATN). Consensus regarding which features are critical for the differentiation of MIS from ATN has not been reached.

Purpose: Determine 1) whether there are dermoscopic features that differentiate early MIS from ATN, and 2) whether non-invasive assessment of genomic biomarkers (LINC00518 and PRAME) can aid in patient management.

Methods: From 2018 to 2023, 56 melanomas were evaluated for 5 clinical and 13 dermoscopic features and melanoma-associated genomic biomarkers. Two groups of ATN with positive and negative genomic biomarkers were randomly selected for comparison.

Results: All melanomas in this study expressed one or both melanoma-associated genomic markers. MIS had an average of 3.90 (range, 2-7) of the 13 dermoscopic features, while invasive melanomas had an average of 4.44 (range, 3-6). Sixteen of 40 (40%) MIS and 3 of 16 (18.8%) invasive melanomas had 3 or fewer dermoscopic features. These findings were comparable to those observed in both ATN groups. The most common dermoscopic features were absent or diminished pigment network, regression structures, and granularity. This combination of features was most helpful in identifying lesions for genomic testing.

Conclusions: Clinical and dermoscopic features alone could not differentiate MIS from ATN. Non-invasive genomic testing helped differentiate lower from higher-risk lesions and aid in clinical management decisions. Genomic testing was particularly helpful in patients with large numbers of lesions with several being considered for biopsy based on clinical and dermoscopic examination. J Drugs Dermatol. 2024;23(9):717-723. doi:10.36849/JDD.8454.

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来源期刊
CiteScore
2.20
自引率
13.30%
发文量
289
审稿时长
3-6 weeks
期刊介绍: The Journal of Drugs in Dermatology (JDD) is a peer-reviewed publication indexed with MEDLINE®/PubMed® that was founded by the renowned Dr. Perry Robins MD. Founded in 2002, it offers one of the fastest routes to disseminate dermatologic information and is considered the fastest growing publication in dermatology. We present original articles, award-winning case reports, and timely features pertaining to new methods, techniques, drug therapy, and devices in dermatology that provide readers with peer reviewed content of the utmost quality. Our high standards of content are maintained through a balanced, peer-review process. Articles are reviewed by an International Editorial Board of over 160 renowned experts.
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