Dermoscopic evaluation of vascular structures of various skin tumors in Japanese patients
Dermoscopic evaluation of vascular structures of various skin tumors in Japanese patients
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DOI：
10.1111/j.1346-8138.2010.00828.x
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发表时间：
2010-04-01
影响因子：
3.1
通讯作者：
Tomita, Yasushi
中科院分区：
文献类型：
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作者：
Sakakibara, Akihiro;Kamijima, Michihiro;Tomita, Yasushi
皮肤肿瘤的皮肤镜分析主要集中在色素结构上。最近，发现几种不同形态的血管与白色受试者的色素或非色素皮肤肿瘤密切相关。因此，这种血管结构的识别已被应用于诊断目的。由于日本患者各种色素皮肤肿瘤血管的统计信息很少，因此我们试图评价各种血管结构与日本患者741例肿瘤病变之间的相关性。102例黑色素瘤中41例、119例基底细胞癌中104例、257例脂溢性角化病中86例、210例皮肤及复合痣中35例、12例鳞状细胞癌中6例、41例Bowen病中16例均在皮肤镜下发现血管结构。树枝状血管和肾小球血管的结构在统计学上分别揭示了BCC和BD的诊断特异性，发夹血管有助于将SK与其他色素性肿瘤区分开来，正如已经在白色患者中报道的那样。在黑色素瘤中观察到的最常见的血管模式是线性-不规则结构，但这种模式在日本患者中的诊断价值低于白色患者，因为其敏感性并不显著高于SCC。我们的研究与以前白色患者的报告之间最显著的差异是黑色素瘤、BCC和DN/CN病变中点状、逗号和多形性血管的频率和敏感性较低;这些血管对日本患者的诊断价值较低。最后，在黑色素瘤中观察到的血管结构的频率随着Breslow肿瘤厚度的增加而沿着上升，并且88%的具有血管的黑色素瘤显示肿瘤厚度大于2 mm。
Dermoscopic analysis of skin tumor has been mainly focused on pigmented structures. Recently, several different morphological types of vessels were found to be well associated with pigmented or non-pigmented skin tumors in white subjects. Therefore, the recognition of such vascular structures has been applied for diagnostic purposes. As little statistical information on the various pigmented skin tumor vessels of Japanese patients has been reported, we therefore tried to evaluate the association between various vascular structures and 741 tumor lesions of Japanese patients. Vascular structures were dermoscopically recognized in 41 of 102 cases of melanoma, 104 of 119 basal cell carcinoma (BCC), 86 of 257 seborrheic keratosis (SK), 35 of 210 dermal and compound nevus (DN/CN), six of 12 squamous cell carcinoma (SCC) and 16 of 41 Bowen disease (BD). The structures of arborizing and glomerular vessels statistically revealed diagnostic specificity for BCC and BD, respectively, and hairpin vessels were helpful for differentiating SK from other pigmented tumors, as already reported in white patients. The most common vascular pattern observed in melanoma was the linear-irregular structure, but this pattern in Japanese patients had less diagnostic value than in white patients, because its sensitivity was not significantly higher than in SCC. The most remarkable differences between our study and previous reports with white patients were low frequency and sensitivity of dotted, comma and polymorphous vessels in lesions of melanoma, BCC and DN/CN; these vessels had less diagnostic value for Japanese patients. Finally, the frequency of vascular structures observed in melanoma rose along with the increase of the Breslow's tumor thickness, and 88% of melanomas with vascular vessels revealed tumor thicknesses of more than 2 mm.