皮肤镜诊断黑素细胞痣、脂溢性角化和日光性角化与组织病理诊断的一致性

目的：评价皮肤镜诊断黑素细胞痣、脂溢性角化、日光性角化的准确度。方法：收集临床怀疑为黑素细胞痣、脂溢性角化和日光性角化的病例，由两位医生参照目前皮肤镜诊断标准对该三种皮肤肿瘤进行盲法独立诊断，并与组织病理结果相对照。结果：与组织病理诊断比较，(1)A、B两位医生使用皮肤镜诊断黑素细胞痣一致率（89.3%、91.2%）、灵敏度（94%、95.2%）、特异度（84.2%、86.8%）、误诊率（15.8%、13.2%）、漏诊率（6%、4.8%）。(2)A、B两位医生使用皮肤镜诊断脂溢性角化一致率（88%、91.7%）、灵敏度（91.7%、95.8%）、特异度（83.6%、86.9%）、误诊率（16.4%、13.5%）、漏诊率（8.3%、4.2%）；(3)A、B两位医生使用皮肤镜诊断日光性角化一致率（84.1%、86.4%）、灵敏度（87.5%、87.5%）、特异度（17.9%、12.5%）、误诊率（82.1%、85.7%）、漏诊率（17.9%、14.3%）。结论：皮肤镜诊断黑素细胞痣、脂溢性角化和日光性角化的结果与病理诊断结果均有较好的一致性。

The consistency of dermoscopy and histopathology in the diagnosis of melanocytic nevus,seborrheic keratosis and solar keratosis

Objective: To determine the accuracy and consistency of dermoscope in the diagnose of mel￣anocytic nevus, seborrheic keratosis and solar keratosis. Methods:Cases from November 2013 to March 2015 which were chinical diagnosed as melanocytic nevus, seborrheic keratosis and solar keratosis were enrolled, including clinical data, clinical pictures, dermoscopic diagnosis and pathological findings. Then two doctors evalauted the dermoscopy seperately, and compared with the histopathological findings. Results:( 1) For the nevus the consistencysensitivity, specificity, misdiagnosis rate,and false dismissal rate between those two eval￣uators were seperatively (89.3%, 91.2%), (94%, 95.2%), (84.2%, 86.8%), (15.8%, 13.2%) and (6%, 4.8%). (2) For the seborrheic keratosis, the consitency, sensitivity, sepecificity, misdiagnosis rate and false dismissal rate were ( 88%, 91. 7%) , ( 91. 7%, 95. 8%) , ( 83. 6%, 86. 9%) , ( 16. 4%, 13. 5%) and (8.3%, 4.2%). (3) For the solar keratosis, the consistency, sensitivity, specificity, misdiagnosis rate and false dismissal rate were (84.1%, 86.4%), (87.5%, 87.5%), (17.9%, 12.5%), (82.1%, 85.7%) and (17.9%, 14.3%). Conclusion:There was a high consistency in the diagnosis of melanocytic nevus and seborrheic keratosis with demoscopy, and solar keratosis by dermoscopy.