皮肤镜对头面部微小色素型基底细胞癌的早期诊断价值

目的:探讨皮肤镜在头面部微小色素型基底细胞癌的早期诊断价值。方法:选择临床疑诊为头面部微小色素型基底细胞癌的患者56例，对所有患者皮损进行皮肤镜检查，留皮肤镜照片。由两名医师参照色素型基底细胞癌皮肤镜特点，采用盲法独立诊断，以组织病理诊断为金标准，通过诊断性试验方法，研究皮肤镜在头面部微小色素型基底细胞癌的灵敏度和特异度及与病理诊断的一致性结果。结果:两名医师皮肤镜诊断头面部微小色素型基底细胞癌的符合率、灵敏度、特异度、误诊率、漏诊率、Youden指数分别是91.1%，94.7%，83.3%，16.6%，5.3%，78%和91.1%，92%，88.9%，11.1%，7.9%，80.9%。两名医师经皮肤镜诊断头面部微小色素型基底细胞癌的水平经卡方检验无统计学差异（P＞0.05）。结论:对于头面部微小色素型基底细胞癌临床误诊率较高，与肉眼比较，皮肤镜可明显提高临床诊断的准确性，在头面部微小色素型基底细胞癌的早期诊断中具有重要价值。

The value of the early diagnosis by dermoscopy for head facial tiny pigmented basal cell carcinoma

Objective:To evaluate value of the early diagnosis by dermoscopy onhead facialtiny pigmented basal cell carcinoma.Methods:56 patients suspected for head facial tiny pigmented basal cell carcinoma with head facial lesions were enrolled in this study.The suspected lesions were examined by dermoscopyand took photos.Two doctors independently made a diagnosis according to the photos from the dermoscopy.The sensitivity,specificity and consistency with histopathology were calculated for dermoscopy in the diagnosis of head facial tiny pigmented basal cell carcinoma.Results:The accuracy,sensitivity,specificity,misdiagnosis rate,rate of missed diagnosis and Youden index of dermoscopy were 91.1%,94.7%,83.3%,16.6%,5.3%,78%,respectively in the diagnosis of head facial tiny pigmented basal cell carcinoma by the doctor A,and 91.1%,92%,88.9%,11.1%,7.9%,80.9% respectively by the doctor B.The level of diagnosis for head facial tiny pigmented basal cell carcinoma of two doctors had no statistical difference(P＞0.05).Conclusion:The misdiagnosis rate of head facialtiny pigmented basal cell carcinoma is high.Compared with naked eye observation,dermoscopy can improve the rate of consistency with histopathology,and it has a significant value of the early diagnosis forhead facial tiny pigmented basal cell carcinoma.