理性的临床检查. 这个病人有或黑色素瘤吗?
1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University Medical Center, NC 27705, USA.
JAMA
|March 13, 1998
概括
早期发现恶性黑色素瘤对于患者的治疗结果至关重要. 诊断辅助工具,如ABCD和7点检查清单,以及医生评估,有助于识别黑色素瘤,尽管准确性在方法和专家之间有所不同.
科学领域:
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 恶性黑色素瘤的发病率在美国显著增加.
- 切除时的瘤厚度是影响黑色素瘤预后的主要因素.
- 通过体检及早检测对于改善患者的治疗结果至关重要.
研究的目的:
- 评估可用于黑色素瘤检测的可用工具的诊断性能.
- 为了比较ABCD检查清单,修订后的7点检查清单和医生全球评估的有效性.
主要方法:
- 审查评估黑色素瘤诊断辅助器的敏感性和特异性的研究.
- 对ABCD检查清单 (不对称性,边界不规则,颜色变化,直径>6毫米) 的数据分析.
- 评估修订的7点检查清单和医生在黑色素瘤检测方面的全球评估.
主要成果:
- 该ABCD检查清单显示高灵敏度 (92%-100%) 和特异性 (98%).
- 修订后的7点检查清单显示了可变的灵敏度 (79%-100%) 和较低的特异性 (30%-37%).
- 医生的整体评估具有很高的特异性 (96%-99%),但具有广泛的敏感性 (50%-97%);皮肤科医生优于非皮肤科医生.
结论:
- 诊断检查清单和医生评估是检测黑色素瘤的有价值的帮助.
- 该ABCD检查清单似乎非常有效,而7点检查清单的特异性较低.
- 医生的经验,特别是皮肤科医生,在黑色素瘤识别中影响诊断灵敏度.
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