The MPATH-Dx reporting schema for melanocytic proliferations and melanoma
The MPATH-Dx reporting schema for melanocytic proliferations and melanoma
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DOI：
10.1016/j.jaad.2013.07.027
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发表时间：
2014-01-01
影响因子：
13.8
通讯作者：
Elmore, Joann G.
中科院分区：
文献类型：
--
作者：
Piepkorn, Michael W.;Barnhill, Raymond L.;Elmore, Joann G.
背景资料：黑色素瘤和痣的组织学诊断可能会出现不一致和错误，可能导致不适当的治疗和伤害。诊断术语是不标准化的，制造混乱的供应商和患者和挑战的investigator.Objective：我们试图描述的发展的病理报告表更精确的研究黑色素瘤和诊断治疗映射工具，以改善患者的护理和一致性treatment.Methods：三个皮肤病理学家独立审查黑色素细胞病变随机选择的皮肤病理学数据库。黑色素细胞病理学评估工具和层次诊断（MPATH-Dx）报告模式从迭代的情况下审查和形式review.Results：在诊断阈值，解释和命名的差异有助于发展的MPATH-Dx组织学报告形式，组病变的相似性，在组织发生和程度的degrees。由于初步结果表明，与特定诊断相比，建议治疗的一致性更高，因此根据MPATH-Dx诊断-治疗映射方案中的治疗共性对MPATH-Dx组织学报告表的不同术语进行分层。局限性：没有变革性的进步，诊断范式，黑色素细胞病变的解释往往仍然subjective.Conclusions：MPATH-Dx诊断治疗映射方案可以减少混乱的那些接收报告分类不同的命名分层的层次结构，建议管理干预措施。
Background: The histologic diagnosis of melanoma and nevi can be subject to discordance and errors, potentially leading to inappropriate treatment and harm. Diagnostic terminology is not standardized, creating confusion for providers and patients and challenges for investigators.Objective: We sought to describe the development of a pathology reporting form for more precise research on melanoma and a diagnostic-treatment mapping tool for improved patient care and consistency in treatment.Methods: Three dermatopathologists independently reviewed melanocytic lesions randomly selected from a dermatopathology database. Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) reporting schema evolved from iterative case review and form revision.Results: Differences in diagnostic thresholds, interpretation, and nomenclature contributed to development of the MPATH-Dx histology reporting form, which groups lesions by similarities in histogenesis and degrees of atypia. Because preliminary results indicate greater agreement regarding suggested treatments than for specific diagnoses, the diverse terminologies of the MPATH-Dx histology reporting form were stratified by commonalities of treatments in the MPATH-Dx diagnostic-treatment mapping scheme. Limitations: Without transformative advances in diagnostic paradigms, the interpretation of melanocytic lesions frequently remains subjective.Conclusions: The MPATH-Dx diagnostic-treatment mapping scheme could diminish confusion for those receiving reports by categorizing diverse nomenclature into a hierarchy stratified by suggested management interventions.