Publicação
Mitoses in cutaneous malignant melanomas : relevance in the prognosis
| Resumo: | Malignant Melanoma is considered the most dangerous skin neoplasia for its potential to invade distant tissues and its associated mortality. Its incidence is considered epidemic. Mitotic rate was recently introduced in the AJCC guidelines as the 2nd most important prognostic factor for thin stage I melanomas, after tumoral thickness, as it strongly correlates with a lower survival rate. Together with ulceration, this variable changes the classification of thin tumors (≤1mm) from T1a to T1b, if at least one mitosis/ mm2 is present. This implies an alteration in patients’ management and treatment. It has been a target of discussion for its accuracy among clinicians and interobserver disparities. The cutoff of one mitosis as also been targeted, since mitotic figures can be found in benign lesions, particularly when immunohistochemistry is used. Mitotic rate has been used to refer patients to sentinel lymph node biopsy, which has also been a disagreement point. Immunohistochemistry in mitoses detection is still under investigation but it is proved to facilitate the observation, although having some objections. Standardization is essential to a more reliable method and adequate patient’s maneuver. |
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| Autores principais: | Marques, Sara Completo, 1992- |
| Assunto: | Melanócito Melanoma Mitose Índice mitótico Biópsia de gânglio sentinela Imuno-histoquímica |
| Ano: | 2016 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Malignant Melanoma is considered the most dangerous skin neoplasia for its potential to invade distant tissues and its associated mortality. Its incidence is considered epidemic. Mitotic rate was recently introduced in the AJCC guidelines as the 2nd most important prognostic factor for thin stage I melanomas, after tumoral thickness, as it strongly correlates with a lower survival rate. Together with ulceration, this variable changes the classification of thin tumors (≤1mm) from T1a to T1b, if at least one mitosis/ mm2 is present. This implies an alteration in patients’ management and treatment. It has been a target of discussion for its accuracy among clinicians and interobserver disparities. The cutoff of one mitosis as also been targeted, since mitotic figures can be found in benign lesions, particularly when immunohistochemistry is used. Mitotic rate has been used to refer patients to sentinel lymph node biopsy, which has also been a disagreement point. Immunohistochemistry in mitoses detection is still under investigation but it is proved to facilitate the observation, although having some objections. Standardization is essential to a more reliable method and adequate patient’s maneuver. |
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