文章：

临床奥尔森分级未能反映光化性角化病的基底生长：一项双中心回顾性分析

Clinical Olsen Grading Does Not Reflect Basal Growth in Actinic Keratoses: Two-Center Retrospective Analysis

原文发布日期：27 November 2025

DOI: 10.3390/cancers17233794

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Actinic keratosis (AK) is a precancerous lesion that may progress into cutaneous cancer. However, the progression potential of individual lesions remains unpredictable. The histological basal proliferation pattern of AKs may serve as a risk marker for progression, yet it cannot be assessed clinically. The objective was to evaluate whether Olsen grading (hyperkeratosis of AKs) and pain as clinical markers correlate with the histological basal proliferation (PRO) and different histological aspects.Methods: In this retrospective two-center study, 380 clinically diagnosed AKs were graded according to the clinical Olsen classification (I–III) and assessed for pain upon palpation. Histologically, they were classified based on their basal- (PRO I–III) and upward-directed (AK I–III) growth patterns, and additional histopathological features, such as acantholysis, were documented.Results: Olsen grading showed weak correlation with the PRO classification (Spearman’s rho = 0.136,p= 0.008), with exact agreement of 36.3% (κ = 0.07). Pain was significantly associated with higher PRO grades (p= 0.005) and acantholysis (p= 0.023) but not with Olsen grades or upward-directed growth (AK I–III).Conclusions: Olsen grading does not allow reliable prediction of basal proliferation patterns in AKs. Its use as a clinical severity scale may suggest progression relevance; however, no substantiated association with histological indicators of transformation could be demonstrated in this study. The presence of pain, however, correlated with high PRO grades and the presence of acantholysis.

摘要翻译： 

背景/目的：光化性角化病是一种可能进展为皮肤癌的癌前病变，但单个病灶的进展潜力仍难以预测。其组织学基底增殖模式可作为进展风险标志物，但无法通过临床评估获得。本研究旨在评估临床标志物——奥尔森分级（AK角化过度程度）与触痛是否与组织学基底增殖模式及不同组织学特征存在相关性。方法：在这项回顾性双中心研究中，对380个临床诊断为AK的病灶进行奥尔森临床分级（I-III级）评估，并记录触痛情况。组织学上根据基底向（PRO I-III级）和向上性（AK I-III级）生长模式进行分类，同时记录棘层松解等附加病理特征。结果：奥尔森分级与PRO分级呈弱相关（Spearman ρ=0.136，p=0.008），完全一致率仅为36.3%（κ=0.07）。疼痛与较高PRO分级（p=0.005）及棘层松解（p=0.023）显著相关，但与奥尔森分级或向上性生长模式（AK I-III级）无显著关联。结论：奥尔森分级不能可靠预测AK的基底增殖模式。虽然其作为临床严重程度分级可能提示进展相关性，但本研究未能证实其与组织学转化指标存在明确关联。然而，疼痛的存在与高PRO分级及棘层松解具有相关性。

原文链接：

Clinical Olsen Grading Does Not Reflect Basal Growth in Actinic Keratoses: Two-Center Retrospective Analysis