Анотація
Актуальність. Злоякісні новоутворення шкіри є досить поширеними пухлинами в загальносвітовій популяції і серед населення України. Основним методом діагностики пухлин шкіри є біопсія, що дозволяє встановити діагноз на ранній стадії і забезпечує виліковування більшості пацієнтів.
Мета роботи. Оцінити сучасні рекомендації щодо біопсії шкіри при діагностиці дерматоонкологічних захворювань.
Матеріали та методи. Пошук джерел інформації проводився за допомогою баз даних PubMed та GoogleScholar із застосуванням таких ключових слів: біопсія шкіри, пухлини шкіри, діагностика, меланома. Серед виявлених джерел виключались роботи без статистичного аналізу, опис окремих випадків, статті без висновків, джерела із дублюючими результатами. Глибина пошуку складала 10 років.
Результати та їх обговорення. В результаті проведеного пошуку виявлено 57 публікацій, які відповідали задекларованій меті. Найпоширенішими методиками є: пункція, бритвенна біопсія, ексцизійна та інцизійна біопсія. Більшість настанов рекомендують проводити ексцизійну біопсію на всю товщину як бажану процедуру при підозрі на меланому. Вказується, що виявлено статистично значущий рівень смертності у групі з пункційною біопсією. У більшості спостережень не було виявлено значущих відмінностей щодо рецидиву меланоми у групах ексцизійної біопсії та пункційного розрізу. Через клінічну різноманітність меланоми відсутня уніфікація у типах біопсії, що проводяться для її діагностики. Найбільш неточним методом виявився метод панч-біопсії, що пов’язано з підвищеним ризиком низького рівня діагностики меланоми.
Висновки. Біопсія шкіри є обов’язковим першим кроком для встановлення остаточного діагнозу пухлини шкіри. Ексцизійна повна біопсія є найбільш виправданою діагностикою у більшості випадків. Раціональна техніка біопсії залишається питанням, що потребує подальшого вивчення.
Посилання
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