Measurement of the Maturation Parameter by Using Computer-Assisted Interactive Image Analysis May Be Helpful in the Differential Diagnosis Between Compound Spitz Nevus and Malignant Melanoma

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Abstract
The so-called maturation parameter (MP) (that is, the ratio of the mean nuclear areas in the deep portion and in the superficial portion of a tumor) was measured and calculated using a computer-assisted interactive image analysis system in 29 compound Spitz nevi (SNs) and 37 primary invasive cutaneous malignant melanomas (MMs), of which 16 and 14 lesions, respectively, measured up to 1 mm in Breslow thickness (that is, thin). The MPs of the SNs and MMs were found to be 0.37-0.89 (mean ± SD, 0.64 ± 0.1) and 0.81-1.16 (mean ± SD, 0.96 ± 0.1), respectively (p < 0.001). The MPs of the subgroups of thin SNs and MMs were 0.56-0.87 (mean ± SD, 0.67 ± 0.1) and 0.86-1.10 (mean ± SD, 0.98 ± 0.1), respectively (p < 0.001). Most of the SNs and MMs had MP values of 0.89, respectively. This pattern of distribution prevailed in the subgroup of thin lesions. Thus, the previously shown difference in MPs between SN and MM for thicker lesions (≥1.0 mm) was demonstrated in this study in thin lesions (≤1.0 mm) as well. Although a relatively small area of overlap in MP values exists between compound SNs and MMs, including the thin ones, below this area the lower the MP value the more likely the diagnosis is SN, and vice versa.