メラノーマ? メラノーマ? メラノーマじゃない!" メラノーマのサブセットで,臨床的に認識されることも困難です
1Department of Pathology, Columbia University College of Physicians and Surgeons, Columbia-Presbyterian Medical Center, New York, NY.
JAMA
|December 25, 1991
まとめ
早期発見の進歩にもかかわらず,著しい数の悪性メラノーマ症例,特にアメラノティック型は,臨床医によって見逃され,診断が遅れて,予後が悪くなる.
科学分野:
- 皮膚科 皮膚科について
- 腫瘍学 腫瘍学
- 病理学 パトロジー
背景:
- 悪性メラノーマは,深刻な皮膚がんです.
- 早期発見は,患者の治療結果を大幅に改善します.
- 臨床診断は,メラノーマの管理における重要なステップです.
研究 の 目的:
- 臨床診断から逃れた悪性メラノーマ症例の発生率と特徴を評価する.
- メラノーマの診断を逃した要因を特定する.
主な方法:
- 1990年以来,組織学的に診断された178件の悪性メラノーマ症例を遡及的に分析した.
- メラノーマが生検前に考慮されたか,後回的に考慮されたかを判断するために,臨床記録のレビュー.
主要な成果:
- 13例 (7.3%) の悪性メラノーマは,病理学的診断の前にまたは後に臨床的に診断されなかった.
- 13件の誤診のうち8件の誤診は,アメラノティックメラノーマに関連していた.
- ほとんどのメラノマは深刻に侵襲的であり,予後不良を示唆しています.
結論:
- 悪性メラノーマの重要なサブカテゴリ,特にアメラノティック変種は,臨床検出を回避し続けています.
- メラノーマの診断上の課題に対処するために,早期発見戦略の改善が必要である.
- 臨床的認識が失敗したため診断が遅れたことは,メラノーマの予後に影響を及ぼします.
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