"Passport of the skin"

Irina Reznik, "Mednovosti"

Russian scientists have developed a system that allows detecting malignant tumors by screening and measuring the clinical parameters of skin neoplasms with sufficiently high accuracy. The joint development of the First Sechenov Moscow State Medical University, P.A. Herzen Moscow State Medical Institute and the NT-MBCI company – an automated system for screening skin neoplasms "Skin Passport" – has no foreign analogues, and this gives it significant prospects after entering the market.

Melanoma is one of the most aggressive forms of cancer known today. Despite the fact that the proportion of melanoma in the structure of skin tumor diseases is small (3-5%), it is this neoplasm that is the most common cause of death in patients with skin oncopathology. In most countries of the world, the incidence of melanoma is increasing by 7% annually. According to the Ministry of Health of the Russian Federation, the prevalence of melanoma in Russia over the past 10 years has increased by 52%, and mortality from it – by 23%.

Among all patients, 83% are already diagnosed with neoplasms with deep levels of invasion into the underlying tissues by the beginning of treatment, very often leading to a fatal outcome. And the only thing that can globally affect survival today is early diagnosis of melanoma. Screening of skin neoplasms is the basis for early detection of melanoma.

To date, there are already automated screening systems that increase the efficiency of the diagnostic process. The design features and unique algorithms of the domestic pre-production software make it more efficient compared to the nearest foreign analogues.

Igor Reshetov, a corresponding member of the Russian Academy of Sciences, Director of the NOC of Plastic Surgery of the First Sechenov Moscow State Medical University, told Mednovosti about the new development.

– Igor Vladimirovich, what kind of skin pathology can your system detect?

– Examination using the "Skin Passport" system is advisable with an increased risk of melanoma. The results of the examination (without diagnostic tools) are subjective, as they depend on the experience of the doctor and his current condition. Our system allows you to objectively and quantitatively assess the condition of the patient's skin, as well as document this data.

The "skin passport" allows you to identify skin tumors such as melanoma (the most dangerous tumor), dysplastic pigmented nevus (a precursor of melanoma), pigmented nevus (a relatively safe tumor).

– When does this "increased risk" arise and is it possible to identify a predisposition to the disease with the help of the system?

– The term "predisposition" should be understood as the risk of getting melanoma. To establish the fact of an increased risk of skin diseases, a cursory glance of an oncologist and a patient survey are enough. If there is an increased risk of skin melanoma, then it is necessary to examine the condition of the skin.

There are known factors that significantly increase the risk of getting melanoma. Among them are such physico-chemical factors as UV radiation, including insolation, chemical carcinogens, ionizing radiation, e/m radiation. Socio-economic: the social status of a person and his profession, place of residence (city, village), the presence of a person most of the time indoors, marital status. Biological: nutritional characteristics, medications, a history of viral infection (rubella, etc.). All these are so-called exogenous factors.

The pharmaceutical company Array BioPharma Inc has developed a drug for the treatment of melanoma associated with a mutation in the NRAS gene. We are talking about a drug based on monoclonal antibodies, called binimetinib.

Endogenous factors include precanceroses (precursors of melanoma). As well as the biological characteristics of a person: race, biometric characteristics of the body, pigmentation disorders of the body, heredity, endocrine factors, reproductive factors in women, concomitant diseases and surgical interventions.

If we talk about risk groups, there are four of them. The least at risk are people belonging to the colored race, as well as representatives of the white race with dark skin and children under 10 years old. The moderate risk group includes people with fair skin, red hair, freckles, as well as those who suffered severe sunburn in childhood. The high-risk group consists of people with sporadic dysplastic nevi, congenital non-cellular nevi. A high risk is also associated with the presence of close relatives who have had melanoma. An extremely high risk is associated with a change in nevus, as well as one or more dysplastic nevi in combination with melanoma in the family history.

– What is the research method you have proposed?

– The method is aimed at automatic detection of new, suspicious and changed nevi. The "Passport of the skin" consists of a scanning system, a photographic background and a workplace of a doctor-operator. This workplace includes a personal computer with special software. The operation of the scanning system is also controlled by a special program.

The system allows you to register clinical images of a visually accessible surface of human skin (full-length photos). The laser sight allows you to control the patient's position. The lighting conditions necessary to achieve high quality of recorded clinical images are provided by flash lamps.

All registered images are processed in an automated mode by a special program. Among the functions of the software are maintaining a database, comparing images "side by side" (during repeated examination, in addition to automatic comparison of images for the current and previous examination, a visual comparison is available: so that the doctor is sure that nothing is missed), as well as detecting new and altered skin neoplasms, counting skin neoplasms on the image map, measurement of clinical parameters of skin neoplasms.

The diameter of pigmented skin neoplasms is automatically measured, their shape is determined (round, oval, arbitrary, scalloped), the time of doubling the volume, the sharpness of the border (sharp, non-sharp), the presence of a depigmented ring, color change and unevenness of pigmentation as a percentage, the intensity of pigmentation. When registering images, the doctor can view them "live" using a magnifying glass. In addition, the program makes it possible, when registering images, to correct the posture of the examined patient according to previously registered images.

The result of the system is the protocols of examination of the patient's skin surface. Each protocol contains a map of the location of detected potentially dangerous skin neoplasms, a table with their clinical images and clinical parameters. As a rule, the operator's doctor writes in the conclusion about the need for additional examination of potentially dangerous skin neoplasms detected, which allows to clarify the diagnosis and make a decision about excision. During repeated examination, the complex of clinical parameters includes parameters describing changes in the size, shape and color of existing skin neoplasms.

– What is the cost of the system as a whole and a one-time examination?

– According to preliminary estimates, the cost of production of the "Passport of the skin" system is 1 million rubles. There is no estimate of the cost of one survey. It is only known that the analogue, inferior to our system in a number of characteristics, has a recommended cost of 6 thousand rubles, and in practice reaches 10 thousand rubles.

– And what is the difference between the "Passport of the skin" and its closest foreign analogues?

– Methods and means that allow screening of pigmented skin neoplasms, in addition to sufficient diagnostic effectiveness, should have sufficient examination speed. And from this point of view, among the existing tools, diagnostic systems that allow recording digital images of the skin surface of entire anatomical areas are the most effective for screening. Such diagnostic systems that allow screening of pigmented skin neoplasms are produced by Canifeld, Derma Medical Systems, FotoFinder.

However, all known foreign diagnostic systems require further additional examination, since they do not fully measure the clinical parameters of pigmented skin neoplasms at the screening stage. They measure dimensions, a certain shape coefficient and a certain brightness coefficient, which are difficult for a doctor to interpret. While our system measures the entire complex of clinical parameters of skin neoplasms.

Portal "Eternal youth" http://vechnayamolodost.ru  04.03.2015