远程皮肤共聚焦显微镜:一项多中心前性研究,评估三级环境中黑色素瘤和角质细胞癌的诊断准确性
Genevieve Ho1, Helena Collgros2, Christoph Sinz3
1Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Journal of the American Academy of Dermatology
|October 10, 2024
概括
远程皮肤共聚焦显微镜 (CCM) 提供准确,安全的皮肤癌诊断,减少不必要的活检. 虽然错过了一些早期的皮肤癌,但它有效地识别了良性病变,改善了对非侵入性诊断的准入.
科学领域:
- 皮肤病学 皮肤病学
- 医疗成像医学成像
- 在瘤学瘤学.
背景情况:
- 皮肤共聚焦显微镜 (CCM) 在体内提供细胞水平的皮肤可视化.
- 使用"存储和转发"方法对CCM (远程-CCM) 的远程解释没有进行评估.
- 远程CCM可能会在多个中心加强对非侵入性皮肤癌诊断的访问.
研究的目的:
- 为了评估远程CCM的诊断准确性.
- 评估远程CCM在临床实践中的安全性和有效性.
- 为了确定远程CCM对不必要的皮肤活检的影响.
主要方法:
- 涉及201个皮肤病变的前性研究,在5个澳大利亚皮肤病学中心进行了活检.
- 在活检之前获取CCM,临床和皮肤镜像.
- 基于云计算的平台用于CCM专家的远程解释,比较诊断与组织病理学.
主要成果:
- 黑色素瘤是最常见的恶性瘤 (47.2%).
- 在44.8%的病变中,远程CCM可能避免了活检 (89/201),其中90%被正确地识别为良性.
- 对恶性瘤检测的敏感度为89%,特异性为64%;没有侵袭性黑色素瘤错过,但错过了7种在位黑色素瘤和2种SCC.
结论:
- 远程CCM的诊断准确度与亲临CCM相比,可以安全地减少不必要的活检.
- 该研究强调了通过远程CCM检测潜在状细胞癌 (SCC) 的局限性.
- 建议包括对边界黑色细胞病变的随访和对潜在的SCCs的谨慎.
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