Dermoscopy adds important information to the assessment of cutaneous melanoma, but the risk of progression is predicted by histologic parameters and therefore requires surgery and histopathologic preparation. Neo-vascularization is crucial for tumor progression and worsens prognosis. The aim of this study was the in vivo evaluation of blood vessel patterns in melanoma with dynamic optical coherence tomography (D-OCT) and the correlation with dermoscopic and histologic malignancy parameters for the risk assessment of melanoma. In D-OCT vessel patterns, shape, distribution and presence/type of branching of 49 melanomas were evaluated in vivo at three depths and correlated with the same patterns in dermoscopy and with histologic parameters after excision. In D-OCT, blood vessel density and atypical shapes (coils and serpiginous vessels) increased with higher tumor stage. The histologic parameters ulceration and Hmb45- and Ki67-positivity increased, whereas regression, inflammation and PD-L1-positivity decreased with risk. CD31, VEGF and Podoplanin correlated with D-OCT vasculature findings. B-RAF mutation status had no influence. Due to pigment overlay and the summation effect, the vessel evaluation in dermoscopy and D-OCT did not correlate well. In summary, atypical vessel patterns in melanoma correlate with histologic parameters for risk for metastases. Tumor vasculature can be noninvasively assessed using D-OCT before surgery.
皮肤镜为皮肤黑色素瘤的评估提供了重要信息，但疾病进展风险需通过组织学参数进行预测，因此需进行手术及组织病理学制备。新生血管形成对肿瘤进展至关重要，且会恶化预后。本研究旨在通过动态光学相干断层扫描（D-OCT）对黑色素瘤血管模式进行活体评估，并将其与皮肤镜及组织学恶性参数相关联，以评估黑色素瘤风险。研究对49例黑色素瘤在三个深度层面进行活体D-OCT血管模式、形态、分布及分支存在/类型的评估，并与切除后皮肤镜的相同模式及组织学参数进行相关性分析。D-OCT显示，血管密度及非典型形态（卷曲状和蜿蜒状血管）随肿瘤分期升高而增加。组织学参数中溃疡形成及Hmb45、Ki67阳性率随风险升高而增加，而退行性变、炎症及PD-L1阳性率则随之降低。CD31、VEGF和Podoplanin与D-OCT血管系统表现相关，B-RAF突变状态无显著影响。由于色素覆盖及叠加效应，皮肤镜与D-OCT的血管评估结果相关性较弱。综上所述，黑色素瘤的非典型血管模式与转移风险的组织学参数具有相关性。肿瘤血管系统可在术前通过D-OCT进行无创评估。
肿瘤(癌症)患者之家