"黑色素瘤吗?我没有. 这不可能是黑色素瘤!' 黑色素瘤的一个子集,它挑战了临床认可
1Department of Pathology, Columbia University College of Physicians and Surgeons, Columbia-Presbyterian Medical Center, New York, NY.
JAMA
|December 25, 1991
概括
尽管早期检测取得了进展,但临床医生忽略了大量恶性黑色素瘤病例,特别是乳腺癌类型,导致诊断延迟和预后较差.
科学领域:
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 恶性黑色素瘤是一种严重的皮肤癌.
- 早期检测显著改善了患者的治疗结果.
- 临床诊断仍然是黑色素瘤管理的关键一步.
研究的目的:
- 评估未经临床诊断的恶性黑色素瘤病例的发生率和特征.
- 为了确定与错过的黑色素瘤诊断相关的因素.
主要方法:
- 从1990年起对178例经组织学诊断的恶性黑色素瘤病例进行了回顾性分析.
- 对临床记录的审查,以确定黑色素瘤是在活检前考虑的还是以后考虑的.
主要成果:
- 13例 (7.3%) 恶性黑色素瘤在病理诊断之前或以后没有临床诊断.
- 在这13个错误诊断中,有8个涉及黑色素瘤.
- 大多数错过的黑色素瘤是深度入侵的,表明预后不佳.
结论:
- 恶性黑色素瘤的一个重要子类别,特别是黑色素瘤变种,继续逃避临床检测.
- 需要改善早期检测策略,以应对黑色素瘤的诊断挑战.
- 由于错过临床识别而延迟诊断会对黑色素瘤的预后产生负面影响.
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