期刊文献+
共找到1篇文章
< 1 >
每页显示 20 50 100
雀斑样恶性黑色素瘤的常规组织学和三维组织学比较
1
作者 MoehrleM. dietz k. +2 位作者 Garbe C. Breuninger H. 李晓莉 《世界核心医学期刊文摘(皮肤病学分册)》 2006年第6期38-38,共1页
Background: Conventional surgery for lentigo maligna melanoma (LMM) is based on normal histological evaluation. However, such evaluation leaves diagnostic gaps. In contrast, complete three-dimensional (3D) histology o... Background: Conventional surgery for lentigo maligna melanoma (LMM) is based on normal histological evaluation. However, such evaluation leaves diagnostic gaps. In contrast, complete three-dimensional (3D) histology of excision margins permits accurate detection of continuously spreading tumour strands like those of LMM. These can be specifically excised in tumour-positive areas with smaller excision margins, and better cosmesis and function. To date there have been no controlled studies of micrographic surgery of LMM. Objectives: Clinical parameters and surgical strategies influencing the prognosis of patients with LMM were evaluated in a prospective study of melanoma patients in the Department of Dermatology of the University of Tübingen (1980-99). Methods: The 292 LMMs comprised 7.4%of 3960 primary stage I and II melanomas treated during this period. One hundred and thirty-six patients in this group (46.6%) underwent surgery on the basis of 3D histology. Results: The geometric mean excision margins were significantly smaller in the 3D histology group (P < 0.0001). Patients with micrographic surgery had fewer recurrences. Multivariate analysis of clinical, histological and surgical variables was carried out, and tumour thickness and 3D histology proved to be independent, significant factors for the prognosis of recurrence-free survival (relative risk, RR 2.08, P < 0.0001 and RR 2.11, P = 0.0037, respectively). There were no melanoma-related deaths in the 3D histology group. All 16 melanoma-related deaths were observed among the 156 patients of the conventional histology group (10.3%). Conclusions: Excision of LMM using 3D histology resulted in a two fold lower probability of recurrence and two fold smaller excision margins. 3D histology is a valuable diagnostic tool and can be used in the management of LMM because of the latter’s pattern of continuous tumour spread. 展开更多
关键词 恶性黑色素瘤 组织学比较 常规组织学检查 三维 雀斑 显微手术切除 外科手术治疗 显微外科手术 手术切缘 临床参数
下载PDF
上一页 1 下一页 到第
使用帮助 返回顶部