Addition of dermoscopy to conventional naked-eye examination in melanoma screening: A randomized study
Addition of dermoscopy to conventional naked-eye examination in melanoma screening: A randomized study
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DOI：
10.1016/j.jaad.2003.09.009
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发表时间：
2004-05-01
影响因子：
13.8
通讯作者：
Giannotti, B
中科院分区：
文献类型：
--
作者：
Carli, P;de Giorgi, V;Giannotti, B
客观的。我们试图评估联合检查（肉眼和皮肤镜检查）与传统肉眼检查在黑色素瘤评估中病变管理的差异；并评估对诊断上模棱两可的病变进行数字化随访的设施对患者治疗的影响。方法。我们在一所大学医院的色素病变诊所进行了一项随机对照试验。 2001年11月1日至2002年3月31日期间共有938名连续受试者符合资格，其中25名因年龄小于12岁而被排除；因此共有 913 名受试者入组。参与者被随机分为联合检查和强制切除可疑病变（B 组），并根据临床医生的决定进行数字随访（C 组），或传统肉眼检查（强制切除可疑病变）（A 组）。相同的色素病变诊所工作人员对所有受试者进行了检查。结果：综合检查确定转诊接受手术的患者比例显着下降（9.0% vs 15.6%）（P =.013）。当对可疑病变进行数字化随访的设施可用时，被归类为携带难以诊断病变的患者的百分比增加（C 组，35.8%；B 组，17.8%；P
Objective. We sought to assess the difference in lesion management between combined examination (naked-eye and dermoscopy) and conventional naked-eye examination in evaluations for melanoma; and to assess the impact on patient treatment of facilities for digital follow-up of diagnostically equivocal lesions.Methods. We conducted a randomized, controlled trial at a pigmented lesion clinic in a university hospital. A total of 938 consecutive subjects presenting between November 1, 2001, and March 31, 2002, were eligible and 25 were excluded because they were younger than 12 years of age; hence 913 subjects were enrolled. Participants were randomized to combined examination with mandatory excision of equivocal lesion (arm B) and with possibility of digital follow-up according to the clinician's decision (arm C), or to conventional naked-eye examination (mandatory excision of equivocal lesion) (arm A). The same pigmented lesion clinic staff examined all subjects.Results: Combined examination determined a significant reduction in the percentage of patients referred for operation (9.0% vs 15.6%) (P =.013). When facilities for digital follow-up of equivocal lesions were available, the percentage of patients classified as harboring lesions difficult to diagnose increased (group C, 35.8%; group B, 17.8%; P