Correlation between clinical atypia and histologic dysplasia in acquired melanocytic nevi

被引:43
作者
Annessi, G
Cattaruzza, MS
Abeni, D
Baliva, G
Laurenza, M
Macchini, V
Melchi, F
Ruatti, P
Puddu, P
Faraggiana, T
机构
[1] IRCCS, Ist Dermopat Immacolata, Lab Dermatopatol, Dept Dermatol, I-00167 Rome, Italy
[2] IRCCS, Ist Dermopat Immacolata, Clin Epidemiol Unit, I-00167 Rome, Italy
关键词
D O I
10.1067/mjd.2001.114580
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: The validity of clinical and histologic criteria in identifying dysplastic nevi is controversial. Recognition of the dysplastic nevus as a distinct clinicopathologic entity requires demonstration of significant agreement between clinical atypia and histologic dysplasia. Objective: We attempted to determine the correlation between clinical atypia and histologic dysplasia in acquired melanocytic nevi and to evaluate the sensitivity and specificity of clinical criteria for dysplastic nevi when compared with histopathologic features. Methods: A total of 940 acquired melanocytic nevi 3 mm in diameter or larger were selected by initially choosing clinically unequivocal dysplastic and nondysplastic nevi and then, from these, histologically unequivocal dysplastic and nondysplastic lesions. The level of concordance between clinical atypia and histologic dysplasia was estimated by κ statistics. Results: Nevi were classified as clinically dysplastic (n = 499) or nondysplastic (n = 441). On the basis of histologic features, 739 were classified as dysplastic and 201 as nondysplastic. Agreement between clinical atypia and histologic dysplasia was found in 432 nevi, that is, a sensitivity of 58.4% (3-5 mm = 27.2%, >5 mm = 69.8%). Agreement between clinical and histologic criteria on the absence of dysplasia was found in 134 nevi, a specificity of 66.6% (3-5 mm = 92.4%, >5 mm = 47.9%). The κ value was 0.17 (3-5 mm = 0.14, >5 mm = 0.10). Conclusion: The limited sensitivity and specificity together with the negligible κ value indicate a poor agreement between clinical and histologic diagnoses of dysplastic nevus. The dysplastic nevus cannot be considered a distinct clinicopathologic entity because histologic dysplasia is found in a range of nevi that may or may not show clinical atypia.
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页码:77 / 85
页数:9
相关论文
共 54 条
[1]  
ACKERMAN AB, 1985, HUM PATHOL, V16, P87
[3]   CORRELATION OF HISTOLOGIC ARCHITECTURAL AND CYTOPLASMIC FEATURES WITH NUCLEAR ATYPIA IN ATYPICAL (DYSPLASTIC) NEVOMELANOCYTIC NEVI [J].
BARNHILL, RL ;
ROUSH, GC ;
DURAY, PH .
HUMAN PATHOLOGY, 1990, 21 (01) :51-58
[4]   INTERCLINICIAN AGREEMENT ON THE RECOGNITION OF SELECTED GROSS MORPHOLOGICAL FEATURES OF PIGMENTED LESIONS - STUDIES OF MELANOCYTIC NEVI-V [J].
BARNHILL, RL ;
ROUSH, GC ;
ERNSTOFF, MS ;
KIRKWOOD, JM .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1992, 26 (02) :185-190
[5]   CURRENT STATUS OF THE DYSPLASTIC MELANOCYTIC NEVUS [J].
BARNHILL, RL .
JOURNAL OF CUTANEOUS PATHOLOGY, 1991, 18 (03) :147-159
[6]  
BARNHILL RL, 1991, CANCER-AM CANCER SOC, V67, P3157, DOI 10.1002/1097-0142(19910615)67:12<3157::AID-CNCR2820671237>3.0.CO
[7]  
2-6
[8]   HISTOLOGIC CORRELATIONS WITH THE CLINICAL-DIAGNOSIS OF DYSPLASTIC NEVUS [J].
BLACK, WC ;
HUNT, WC .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 1990, 14 (01) :44-52
[9]  
CARLI P, 1994, EUR J DERMATOL, V4, P35
[10]  
CLARK WH, 1989, SEMIN DERMATOL, V8, P229