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Increased use of Dermoscopy in Primary Healthcare Following the Implementation of Teledermatology in Southeast Sweden: A Retrospective Cohort Study of 2,137 Patients. 瑞典东南部实施远程皮肤病学后,基层医疗机构增加了皮肤镜的使用:一项针对 2,137 名患者的回顾性队列研究。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-13 DOI: 10.2340/actadv.v104.40890
Christofer Sahin, Mattias Carlsson, Fredrik Munir Ehrlington, Emanuela Micu, Magnus Falk

In the last 5 decades there has been a steady increase in skin cancer incidence globally. As patients wait for treatment before or after referral, the prognosis for those with melanoma worsens. Teledermatology was introduced to help reduce waiting times. The objective of this study was to investigate how the introduction of teledermatology affected management of skin tumours, from primary care physicians to dermatologists. A retrospective cohort study was performed 1 year before and 1 year after introduction of teledermatology in Östergötland County, Sweden. Patients were included from 3 primary healthcare centres by 3 independent observers. A total of 2,139 patients were included in the study. The 2 cohorts were well matched. At 2 of the 3 primary healthcare centres there was a significant increase in the use of dermoscopy, and almost 66% of all referrals were teledermatological in the year following its introduction. There was a trend towards higher diagnostic accuracy in the post-teledermatology cohort. No apparent effect on melanoma referral times was observed. The results of this study confirm previous findings showing the value of teledermatology as well as a novel finding of an increase in dermoscopy use in primary healthcare settings.

过去 50 年间,全球皮肤癌发病率持续上升。由于患者在转诊前或转诊后等待治疗,黑色素瘤患者的预后恶化。远程皮肤病学的引入有助于缩短等待时间。本研究旨在探讨远程皮肤病学的引入如何影响从初级保健医生到皮肤科医生对皮肤肿瘤的管理。瑞典Östergötland县在引入远程皮肤科之前和之后各进行了一年的回顾性队列研究。3名独立观察员对3个初级医疗中心的患者进行了统计。共有 2,139 名患者参与了研究。两个组群的匹配度很高。在 3 个初级保健中心中的 2 个中心,皮肤镜的使用率显著提高,在引入皮肤镜后的一年中,几乎 66% 的转诊都是远程皮肤镜检查。采用远程皮肤镜检查后,诊断准确率呈上升趋势。对黑色素瘤转诊时间没有明显影响。这项研究的结果证实了之前的研究结果,显示了远程皮肤学的价值,以及在初级医疗机构中皮肤镜使用率增加的新发现。
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引用次数: 0
Intercellular, Linear Direct Immunofluorescence Staining Pattern of Sweat Glands and Hair Follicles may be Used as a Diagnostic Marker for Pemphigus Vulgaris in Cases where Epidermis is Missing. 在表皮缺失的病例中,汗腺和毛囊的细胞间线性直接免疫荧光染色模式可作为丘疹性荨麻疹的诊断标志。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-13 DOI: 10.2340/actadv.v104.40620
Orsolya N Horvath, Michaela Maurer, Vivian Wietzke, Victoria Fischer, Lars E French, Miklós Sárdy

Due to its rarity, it takes months for patients to be correctly diagnosed with pemphigus vulgaris. This delay can be exacerbated by factors such as incorrect biopsy site selection. When the epidermis detaches from the dermis, evaluating fluorescence patterns is impossible. This monocentric, retrospective study aimed to assess the clinical significance of the honeycomb-like staining pattern of adnexal structures in patients with pemphigus vulgaris. The study was conducted in Munich, from 1 January 2012 to 31 December 2020. Forty-four biopsy samples for direct immunofluorescence microscopy from pemphigus patients along with 44 samples from control patients were included. The fluorescence intensity of adnexal structures did not differ significantly from that of the epidermis in pemphigus, except for hair follicles and sweat glands with C3 staining, where the epidermis showed stronger fluorescence. The sensitivity for the characteristic fluorescence pattern of at least 1 adnexal structure was 88.64% (n = 39/44, 95% CI 75.44% to 96.21%), with 100% specificity. The positive predictive value of adnexal fluorescence was 100%, and the negative predictive value was 89.8%. It was found that the honeycomb-like staining pattern of sweat glands, sweat gland ducts, and hair follicles is a highly specific marker for pemphigus vulgaris.

由于其罕见性,患者需要几个月的时间才能被正确诊断为寻常型丘疹性荨麻疹。活检部位选择不正确等因素可能会加剧这种延误。当表皮与真皮分离时,就无法评估荧光模式。这项单中心回顾性研究旨在评估寻常型天疱疮患者附件结构蜂窝状染色模式的临床意义。研究于 2012 年 1 月 1 日至 2020 年 12 月 31 日在慕尼黑进行。研究纳入了 44 份丘疹性荨麻疹患者的活检样本和 44 份对照组患者的样本,用于直接免疫荧光显微镜检查。在丘疹性荨麻疹患者中,附件结构的荧光强度与表皮结构的荧光强度没有明显差异,但毛囊和汗腺的C3染色除外,表皮的荧光强度更强。至少一个附件结构的特征性荧光模式的敏感性为 88.64%(n = 39/44,95% CI 75.44% 至 96.21%),特异性为 100%。附件荧光的阳性预测值为 100%,阴性预测值为 89.8%。研究发现,汗腺、汗腺导管和毛囊的蜂窝状染色模式是寻常型丘疹性荨麻疹的高度特异性标志物。
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引用次数: 0
Psychiatric Comorbidities of Childhood-onset Atopic Dermatitis in Relation to Eczema Severity: A Register-based Study among 28,000 Subjects in Finland. 儿童期特应性皮炎的精神并发症与湿疹严重程度的关系:对芬兰 28,000 名受试者进行的登记研究。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-13 DOI: 10.2340/actadv.v104.40790
Amanda Blanco Sequeiros, Suvi-Päivikki Sinikumpu, Jari Jokelainen, Laura Huilaja

Data on the severity of childhood-onset atopic dermatitis (AD) in relation to psychiatric comorbidities is scarce, even though AD predisposes to psychiatric comorbidities and the commonness of childhood-onset AD and its significance in disease progression are recognized. The purpose of this nationwide, register-based study of child patients diagnosed with AD in Finland between 1987 and 2017 was to determine how psychiatric comorbidities of AD patients differ depending on the disease severity of childhood-onset AD. AD severity was assessed by purchased AD treatment and risk of comorbidities was analyzed by the age of 18 and 30 years. The main finding of our study is that risk of several psychiatric disorders, i.e., depression, anxiety disorders and bipolar disorder, increased by the AD severity in childhood-onset AD already at young age. No difference was found for behavioral disorders, including hyperkinetic disorder, depending on AD severity. Childhood-onset AD is associated with different psychiatric comorbidities depending on AD severity, which supports the importance of mental health evaluation in AD patients.

尽管儿童特应性皮炎(AD)易导致精神疾病,而且儿童特应性皮炎的常见性及其在疾病进展中的重要性已得到公认,但有关儿童期特应性皮炎(AD)严重程度与精神疾病合并症关系的数据却很少。这项对1987年至2017年间芬兰确诊为AD的儿童患者进行的全国性登记研究,旨在确定AD患者的精神疾病合并症因儿童期发病AD的疾病严重程度不同而有何差异。AD严重程度通过购买的AD治疗进行评估,合并症风险则按18岁和30岁进行分析。我们研究的主要发现是,童年发病型 AD 患者在年轻时罹患抑郁症、焦虑症和躁狂症等几种精神疾病的风险会随着 AD 严重程度的增加而增加。在行为障碍(包括过度运动障碍)方面,则未发现因AD严重程度不同而存在差异。儿童期发病的注意力缺失症会因注意力缺失症的严重程度不同而导致不同的精神疾病合并症,这也证明了对注意力缺失症患者进行心理健康评估的重要性。
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引用次数: 0
Management of Melanoma in Elderly Patients over 80 Years. 80 岁以上老年患者的黑色素瘤管理。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-13 DOI: 10.2340/actadv.v104.41029
Héloïse Jourdain, Justine Lavaud, Clémentine Descours, Emilie Auditeau, Philippe Bernard

Melanoma is a malignant tumour with a poorer prognosis in stage III and IV patients. Development of effective therapies for the treatment of advanced melanoma has led to an improvement in survival. Furthermore, the French population is ageing, and treatment of melanoma in this population has several specific limitations. This descriptive, retrospective, single-centre study collected data on the diagnostic and therapeutic management of patients with melanoma of Breslow ≥ 1 mm or of unknown primary and metastatic spread, at Limoges University Hospital, between 2018 and 2022, and compared the results obtained between 2 groups: under 80 and over 80 years of age; 344 patients were included. The extension work-up was more frequently complete and the sentinel lymph node technique more frequently performed in patients under 80. Wide excision was more frequently in accordance with guidelines in patients over 80. Adjuvant or first-line metastatic treat-ment was more frequently instituted in patients under 80, but no difference was found as regards the second and third lines, the frequency of adverse events, and the reason for stopping treatment. Our study supports similar management of elderly and young subjects, given the safety profile and efficacy of treatments.

黑色素瘤是一种恶性肿瘤,III 期和 IV 期患者的预后较差。治疗晚期黑色素瘤的有效疗法的开发提高了患者的生存率。此外,法国人口正在老龄化,对这一人群的黑色素瘤治疗存在一些特殊的局限性。这项描述性、回顾性、单中心研究收集了2018年至2022年间利摩日大学医院对布雷斯罗≥1毫米或原发和转移扩散情况不明的黑色素瘤患者的诊断和治疗管理数据,并比较了80岁以下和80岁以上两组患者的结果;共纳入344名患者。在80岁以下的患者中,扩展检查更为完整,前哨淋巴结技术更为常用。80岁以上的患者更常根据指南进行大范围切除。80岁以下的患者更常接受辅助治疗或一线转移治疗,但在二线和三线治疗、不良反应发生率和停止治疗的原因方面没有发现差异。考虑到治疗的安全性和有效性,我们的研究支持对老年和年轻患者采取类似的治疗方法。
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引用次数: 0
Is the Use of the Extended (Meth)acrylate Series - Nails Justified? Characterization of Nail Acrylate Allergy in a Tertiary Medical Centre. 使用丙烯酸(甲基)酯扩展系列--指甲是否合理?一家三级医疗中心的丙烯酸甲酯过敏症特征。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-12 DOI: 10.2340/actadv.v104.41079
Joel Dascalu, Sophia Polansky, Ziad Khamaysi, Emily Avitan-Hersh, Mariela J Nevet

Methacrylate allergy is a common cause of allergic contact dermatitis, and its incidence has surged over the past decade. Consequently, the primary sensitizing agent, 2-hydroxyethyl methacrylate, was recently added to the European Baseline Series of contact allergens. This study aimed to assess the added value of testing for allergens included in the (Meth)Acrylate Series - Nails, in addition to 2-hydroxyethyl methacrylate, as well as to characterize patients who may benefit from more extensive testing. A retrospective analysis of medical records of patch-tested patients was conducted between June 2013 and July 2022. Among the 3,828 patients who underwent patch testing, 396 were tested with the (Meth)Acrylate Series - Nails; 153 (38.6%) of those patients tested positive for at least 1 acrylate. The most common hapten was 2-hydroxyethyl methacrylate (85.6%), followed by hydroxypropyl methacrylate (85.0%) and ethylene glycol dimethacrylate (80.4%). In our study, 22/153 patients (14.4%) would have been missed if tested only for 2-hydroxyethyl methacrylate. The analysis showed that including hydroxypropyl methacrylate and ethylene glycol dimethacrylate improved detection rate to 98%, rendering the use of the entire tray unnecessary in most cases.

甲基丙烯酸酯过敏是导致过敏性接触性皮炎的常见原因,其发病率在过去十年中急剧上升。因此,2-羟乙基甲基丙烯酸酯这种主要致敏物质最近被列入了欧洲接触性过敏原基线系列。本研究旨在评估除甲基丙烯酸 2-羟乙基酯外,检测《(甲基)丙烯酸酯系列-指甲》中过敏原的附加价值,以及可能受益于更广泛检测的患者的特征。我们在 2013 年 6 月至 2022 年 7 月期间对接受贴片测试的患者病历进行了回顾性分析。在接受贴片检测的3828名患者中,有396人接受了(甲基)丙烯酸酯系列--指甲的检测;其中153人(38.6%)至少对一种丙烯酸酯检测呈阳性。最常见的单体是甲基丙烯酸羟乙酯(85.6%),其次是甲基丙烯酸羟丙酯(85.0%)和乙二醇二甲基丙烯酸酯(80.4%)。在我们的研究中,如果只检测甲基丙烯酸羟乙酯,22/153 名患者(14.4%)会被漏检。分析表明,将甲基丙烯酸羟丙酯和乙二醇二甲基丙烯酸酯包括在内可将检出率提高到 98%,从而在大多数情况下无需使用整个托盘。
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引用次数: 0
Peripheral Blood Mean Platelet Volume and the Ratio of Mean Platelet Volume to Platelet Count as Prognostic Biomarkers in Patients with Cutaneous Angiosarcoma of the Head and Neck: A Retrospective Cohort Study. 作为头颈部皮肤血管肉瘤患者预后生物标志物的外周血平均血小板体积和平均血小板体积与血小板计数之比:一项回顾性队列研究
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.2340/actadv.v104.42227
Ken Horisaki, Tomoki Taki, Shoichiro Mori, Mao Okumura, Masashi Akiyama
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引用次数: 0
Effect of betablockers on the course of Martorell hypertensive ulcers: a retrospective study. 贝特受体阻滞剂对马多雷尔高血压溃疡病程的影响:一项回顾性研究。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.2340/actadv.v104.41087
Lucy Cleusix, Olesya Pavlova, Emmanuella Guenova, François Kuonen

Martorell hypertensive ulcer (MHU) represents a painful, difficult-to-handle condition associated with peri-pheral, subcutaneous arteriolosclerosis caused by chronic hypertensive disease. Betablockers are effective for and widely used to treat hypertensive disease but are reported to exacerbate peripheral vasoconstriction. The effect of betablockers on pre-existing arteriolosclerosis and the course of MHU is, however, unknown. A retrospective study to assess the effect of betablockers on the course and response to treatment of MHU was conducted. Clinical and histopathological data were collected of patients treated for MHU at the authors' institution between 2014 and 2023 and a side-by-side comparison was performed of patients taking betablockers or not. Analysis focused on MHU severity at presentation, analgesic use, response to therapeutic intervention, and alterations of cutaneous arterioles. The study reports significantly larger ulcers and more frequent use of opioids in patients taking betablockers, while no significant difference was observed in terms of MHU response to treatment. Significantly increased luminal obstruction of peripheral cutaneous arterioles was found in patients taking beta-blockers. Based on these data, betablockers may have a negative effect on the course of MHU and should be carefully assessed in patients with MHU.

马托里尔高血压溃疡(MHU)是一种疼痛难忍的疾病,与慢性高血压疾病引起的皮周、皮下动脉硬化有关。倍他受体阻滞剂对治疗高血压疾病有效并被广泛使用,但据报道会加剧外周血管收缩。然而,倍他受体阻滞剂对已存在的动脉硬化和 MHU 病程的影响尚不清楚。我们开展了一项回顾性研究,以评估受体阻滞剂对 MHU 病程和治疗反应的影响。研究收集了2014年至2023年期间在作者所在机构接受治疗的MHU患者的临床和组织病理学数据,并对是否服用受体阻滞剂的患者进行了并列比较。分析的重点是MHU发病时的严重程度、镇痛剂的使用、对治疗干预的反应以及皮肤动脉血管的改变。研究报告显示,服用倍他受体阻滞剂的患者溃疡面积明显更大,使用阿片类药物的频率更高,而在MHU对治疗的反应方面没有观察到明显差异。研究发现,服用贝特类受体阻滞剂的患者外周皮肤动脉血管的管腔阻塞明显增加。根据这些数据,β-受体阻滞剂可能会对 MHU 病程产生负面影响,因此应仔细评估 MHU 患者的病情。
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引用次数: 0
A Systematic Review of 207 Studies Describing Validation Aspects of the Dermatology Life Quality Index. 对描述皮肤科生活质量指数验证方面的 207 项研究进行系统回顾。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.2340/actadv.v104.41120
Jui Vyas, Jeffrey R Johns, Faraz M Ali, John R Ingram, Sam Salek, Andrew Y Finlay

This study systematically analysed peer-reviewed publications describing validation aspects of the Dermatology Life Quality Index (DLQI) and used Naicker's Critically Appraising for Antiracism Tool to assess risk of racial bias. Seven online databases were searched from 1994 until 2022 for articles containing DLQI validation data. Methodology followed PRISMA guidelines, the protocol was registered in PROSPERO, and articles reviewed independently by two assessors. Of 1,717 screened publications, 207 articles including 58,828 patients from >  49 different countries and 41 diseases met the inclusion criteria. The DLQI demonstrated strong test-retest reliability; 43 studies confirmed good internal consistency. Twelve studies were performed using anchors to assess change responsiveness with effect sizes from small to large, giving confidence that the DLQI responds appropriately to change. Forty-two studies tested known-groups validity, providing confidence in construct and use of the DLQI over many parameters, including disease severity, anxiety, depression, stigma, scarring, well-being, sexual function, disease location and duration. DLQI correlation was demonstrated with 119 Patient Reported Outcomes/Quality of Life measures in 207 studies. Only 15% of studies explicitly recruited minority ethnic participants; 3.9% stratified results by race/ethnicity. This review summarizes knowledge concerning DLQI validation, confirms many strengths of the DLQI and identifies areas for further validation.

本研究系统分析了描述皮肤科生活质量指数(DLQI)验证方面的同行评审出版物,并使用奈克的 "反种族主义批判性评估工具 "评估种族偏见风险。从 1994 年到 2022 年,我们在七个在线数据库中搜索了包含 DLQI 验证数据的文章。研究方法遵循 PRISMA 指南,研究方案在 PROSPERO 中注册,文章由两名评审员独立评审。在筛选出的 1717 篇出版物中,有 207 篇文章符合纳入标准,其中包括来自 49 个不同国家和 41 种疾病的 58828 名患者。DLQI显示出很强的测试-再测可靠性;43项研究证实了良好的内部一致性。有 12 项研究使用锚点来评估变化反应性,其效应大小由小到大,从而使人相信 DLQI 能够对变化做出适当的反应。有 42 项研究测试了已知组的有效性,从而使人们对 DLQI 在疾病严重程度、焦虑、抑郁、耻辱感、瘢痕、幸福感、性功能、发病部位和持续时间等许多参数方面的构建和使用有了信心。在 207 项研究中,DLQI 与 119 项 "患者报告结果"/"生活质量 "测量指标之间存在相关性。只有 15% 的研究明确招募了少数族裔参与者;3.9% 的研究按种族/民族对结果进行了分层。本综述总结了有关 DLQI 验证的知识,确认了 DLQI 的许多优点,并指出了需要进一步验证的领域。
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引用次数: 0
The Importance of Readability: A Guide to Understanding Alopecia Areata through Multilingual Online Resources. 可读性的重要性:通过多语言在线资源了解脱发症的指南》。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.2340/actadv.v104.41046
Tomasz Skrzypczak, Anna Skrzypczak, Jacek C Szepietowski

Online resources play a vital role in patient education, yet the readability of alopecia areata-related materials remained understudied. A thorough analysis of online alopecia areata-related materials across 5 languages was conducted using Google search. Search terms "alopecia areata" and "alopecia areata treatment" were translated and queried, generating search result lists. The first 50 articles from each list were evaluated for suitability. The materials were categorized into 2 main groups: those focusing on alopecia areata itself and those addressing its treatment. Treatment materials were further divided into subgroups, including Janus kinase inhibitors and other treatment options. Readability was evaluated using the Lix score. The analysis included 251 articles in English, German, French, Italian, and Spanish. The overall mean Lix score was 52 ± 8, which classified them as very hard to comprehend. Articles on alopecia areata treatment had a mean Lix score of 55 ± 8, which was significantly higher (p < 0.001) than those on alopecia areata itself, 50 ± 8. alopecia areata-treatment articles dedicated to JAK inhibitors had an average Lix score of 57 ± 10 and it was significantly higher (p = 0.043) than those on other treatment, 53 ± 6. Online resources on alopecia areata and its treatments remained challenging to comprehend, particularly regarding JAK inhibitors. Improving clarity in patient education materials is crucial for informed decision-making and therapeutic relationships.

在线资源在患者教育中发挥着重要作用,但脱发相关资料的可读性仍未得到充分研究。我们使用谷歌搜索对 5 种语言的在线斑秃相关资料进行了全面分析。对搜索词 "斑秃 "和 "斑秃治疗 "进行翻译和查询,生成搜索结果列表。我们对每个列表中的前 50 篇文章进行了适当性评估。这些资料被分为两大类:侧重于斑秃本身的资料和治疗斑秃的资料。治疗资料又分为几个子组,包括 Janus 激酶抑制剂和其他治疗方案。可读性采用 Lix 评分进行评估。分析包括 251 篇英语、德语、法语、意大利语和西班牙语文章。总体平均 Lix 得分为 52 ± 8,属于非常难懂的文章。有关斑秃治疗的文章的平均 Lix 得分为 55 ± 8,明显高于其他文章(p
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引用次数: 0
High BRAF V600 Mutation Level Associated with Worse Outcome in Metastatic Melanoma Patients Receiving BRAF and MEK Inhibitors. 高 BRAF V600 基因突变水平与接受 BRAF 和 MEK 抑制剂治疗的转移性黑色素瘤患者的不良预后有关。
IF 3.5 4区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.2340/actadv.v104.40913
Ariane Fizazi, Chris Serrand, Alexandre Evrard, Blanche Bergeret, Pierre-Emmanuel Stoebner, Myriam Marque

The prognostic value of BRAF V600 mutation level on clinical outcomes in patients with BRAF V600-mutated metastatic melanoma treated with BRAF and MEK inhibitors remains uncertain. The association was retrospectively analysed between BRAF V600 mutation level (defined as the ratio of the quantification of the BRAF V600 allele to the percentage of tumoral cells in the sample analysed) and progression-free and overall survival (PFS and OS, respectively) and 3-month response rate in a cohort of 58 patients with metastatic melanoma who harboured BRAF V600E/K mutations and received dual targeted-therapy BRAF/MEK inhibitors. The BRAF mutation level cut-off determined by the area under the receiver operating characteristic curve after internal validation by bootstrap methods was 0.44. Risk of poor PFS and OS was associated with BRAF V600 mutation level > 0.44 on multivariate analysis (p = 0.02 and p = 0.02, respectively) after adjusting for major confounding factors (age, sex, lactate dehydrogenase level, brain metastasis, and treatment line). No association was found between BRAF mutation level and 3-month response rate. Our study shows that high BRAF V600 mutation level in melanoma tissue was associated with poor prognosis in patients with metastatic melanoma treated with BRAF and MEK inhibitors.

BRAF V600突变水平对接受BRAF和MEK抑制剂治疗的BRAF V600突变转移性黑色素瘤患者临床预后的影响仍不确定。研究人员回顾性分析了58例携带BRAF V600E/K突变并接受BRAF/MEK双靶向抑制剂治疗的转移性黑色素瘤患者的BRAF V600突变水平(定义为BRAF V600等位基因的定量与分析样本中肿瘤细胞百分比的比值)与无进展生存期、总生存期(分别为PFS和OS)和3个月应答率之间的关系。通过引导法进行内部验证后,根据接收者操作特征曲线下面积确定的 BRAF 突变水平临界值为 0.44。在调整了主要混杂因素(年龄、性别、乳酸脱氢酶水平、脑转移和治疗方案)后,进行多变量分析发现,PFS 和 OS 差的风险与 BRAF V600 突变水平 > 0.44 相关(分别为 p = 0.02 和 p = 0.02)。BRAF突变水平与3个月应答率之间没有关联。我们的研究表明,在接受BRAF和MEK抑制剂治疗的转移性黑色素瘤患者中,黑色素瘤组织中的高BRAF V600突变水平与不良预后有关。
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引用次数: 0
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Acta dermato-venereologica
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