Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma:: A multicenter study
Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma:: A multicenter study
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DOI：
10.1016/j.jaad.2004.06.028
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发表时间：
2004-12-01
影响因子：
13.8
通讯作者：
González, S
中科院分区：
文献类型：
--
作者：
Nori, S;Rius-Díaz, F;González, S
背景：目前基底细胞癌（BCC）的标准诊断程序是侵入性活检后的组织学检查。反射模式共聚焦显微镜（RCM）提供了非侵入性的高分辨率成像人体皮肤在vivo.Objective：本研究的目的是探讨的敏感性和特异性的RCM诊断BCC.Methods：这是一个回顾性研究的RCM图像从4个机构的152皮肤病变代表各种良性和恶性诊断。对这152个病灶进行了临床检查，并对所有83个检测到的BCC进行了活检记录。在前期研究的基础上，建立了一套诊断基底细胞癌的共聚焦成像标准，包括5个与组织学相关的标准，如存在细长的单形核。由一名新手审查员对152个病灶的图像进行盲法回顾性分析，以确定这5个RCM诊断BCC标准的敏感性和特异性。结果：两个或两个以上的诊断标准对BCC的诊断敏感性为100%，而4个或4个以上的RCM诊断标准对BCC的诊断特异性为95.7%，敏感性为82.9%。发现这些结果在研究中心和BCC亚型之间几乎没有变异性。结论：RCM为BCC的无创诊断提供了一种敏感、特异的工具。
Background: The Current standard diagnostic procedure for basal cell carcinoma (BCC) is histologic examination after invasive biopsy. Reflectance-mode confocal microscopy (RCM) offers noninvasive high-resolution imaging of human skin in vivo.Objective: The objective Of this Study was to explore the sensitivity and specificity of RCM for diagnosis of BCC.Methods: This was a retrospective study of RCM images from 4 institutions of 152 skin lesions representing a variety of benign and malignant diagnoses. These 152 lesions were examined clinically, with biopsies recorded for all the 83 BCCs detected. Based on a previous study, a set of 5 histologically correlated confocal imaging criteria for diagnosing BCC was established, eg, the presence of elongated monomorphic nuclei. Blinded retrospective analysis of the images from the 152 lesions was carried Out by a single novice reviewer to determine the sensitivity and specificity of these 5 RCM criteria for diagnosing BCC. The accuracy of combining the probability of BCC based on examination of clinical photographs with the predicted probability of BCC based on confocal criteria was also evaluated.Results: The presence of two or more criteria is 100% sensitive for the diagnosis of BCC, and with 4 or more RCM criteria present the specificity was 95.7% and sensitivity was 82.9%. These results were found to have little variability across study sites and across BCC subtypes. The combination of RCM with photography-based predictions of clinical probability of BCC significantly improved the accuracy for noninvasive diagnosis of BCC.Conclusion: RCM offers a sensitive and specific tool for the noninvasive diagnosis of BCC in vivo.