皮肤镜在微小色素型基底细胞癌诊断中的初步研究

目的 评价皮肤镜在微小色素型基底细胞癌诊断中的价值.方法 体表疑似微小(皮损直径＜5 mm)色素型基底细胞癌患者58例,男19例,女39例；年龄16～82岁；病程3个月至25年.对每例皮损进行皮肤镜检查,留皮肤镜照片.由两名医生参照色素型基底细胞癌皮肤镜特点,仅根据照片盲法独立进行诊断.以病理诊断为金标准,通过诊断性试验的研究方法,研究皮肤镜在微小色素型基底细胞癌诊断中的敏感度、特异度及一致性.结果 58例患者中36例经组织病理学诊断为基底细胞癌,医生A皮肤镜诊断为色素型基底细胞癌41例,不是色素型基底细胞癌17例；医生B皮肤镜诊断为色素型基底细胞癌40例,不是色素型基底细胞癌18例.与病理诊断相比,两名医生皮肤镜诊断色素型基底细胞癌的灵敏度、特异度、Youden指数及Kappa值分别为97.22％、72.73％、69.95％、0.732 (P＞ 0.05)和97.22％、77.27％、74.49％、0.772(P＞0.05).结论 皮肤镜对微小色素型基底细胞癌诊断与组织病理学检查结果有较好的一致性.

Dermoscopy in the diagnosis of tiny pigmented basal cell carcinoma: a preliminary evaluation

Objective To evaluate the diagnostic ability of dermoscopy in tiny pigmented basal cell carcinoma (BCC).Methods Fifty-eight patients with lesions measuring less than 5 mm in diameter and suspected for tiny pigmented basal cell carcinoma were enrolled in this study.The patients included 19 males and 39 females aging from 16 to 82 years.The disease course varied from 3 months to 25 years.The suspected lesions were examined by dermoscopy,then,two dermatologists independently made a diagnosis according to the findings on dermoscopy.Tissue specimens were also obtained from the suspected lesions for pathological diagnosis.The sensitivity,specificity and consistency with histopathology were calculated for dermoscopy in the diagnosis of tiny pigmented basal cell carcinoma.Results Of the 58 patients,36 were diagnosed with basal cell carcinoma according to pathological findings.Based on the dermoscopic features,41 cases were diagnosed as pigmented basal cell carcinoma by the dermatologist A,and 40 by the dermatologist B.The sensitivity,specificity,Youden index and Kappa value of dermoscopy were 97.22％,72.73％,69.95％ and 0.732 (P ＞ 0.05) respectively in the diagnosis of tiny pigmented basal cell carcinoma by the dermatologist A,97.22％,77.27％,74.49％ and 0.772 (P ＞ 0.05) respectively by the dermatologist B.Conclusion There is a high consistency between dermoscopy and histopathology in the diagnosis of tiny pigmented basal cell carcinoma.