Duff C G, Melsom D, Rigby H S, Kenealy J M, Townsend P L
Department of Plastic and Reconstructive Surgery, Frenchay Hospital, Bristol, UK.
Br J Plast Surg. 2001 Jun;54(4):317-21. doi: 10.1054/bjps.2000.3561.
We investigated whether the pigmented-lesion clinic (PLC) run by the Department of Plastic and Reconstructive Surgery at Frenchay Hospital was effective in making and excluding the diagnosis of malignant melanoma, by looking at the pattern of referrals over time, the number of melanomas excised and melanomas in which the diagnosis was delayed or missed. We also investigated whether the PLC was having an effect on the thicknesses of melanomas excised. All 9968 patients attending the PLC between 1 January 1993 and 31 December 1998 were included in the study and 586 malignant melanomas were diagnosed; 24.7% of excisions led to the diagnosis of malignant melanoma. Seven invasive melanomas and two lentigo malignas were missed. There was one histological false negative. The PLC has a sensitivity of 98.5% and specificity of 89.2% for the diagnosis of melanoma; the negative predictive value is 99.9%. The PLC is effective in rapidly making or excluding the diagnosis of malignant melanoma, but has had no effect on the average thickness of melanomas excised over the 6 year study period.
我们通过观察随时间推移的转诊模式、切除的黑色素瘤数量以及诊断延迟或漏诊的黑色素瘤情况，研究了法国医院整形与重建外科开设的色素沉着病变诊所（PLC）在诊断和排除恶性黑色素瘤方面是否有效。我们还研究了PLC对切除的黑色素瘤厚度是否有影响。1993年1月1日至1998年12月31日期间到PLC就诊的所有9968例患者均纳入本研究，共诊断出586例恶性黑色素瘤；24.7%的切除病例诊断为恶性黑色素瘤。漏诊了7例侵袭性黑色素瘤和2例恶性雀斑样痣。有1例假阴性组织学结果。PLC诊断黑色素瘤的敏感性为98.5%，特异性为89.2%；阴性预测值为99.9%。PLC在快速诊断或排除恶性黑色素瘤方面是有效的，但在为期6年的研究期间，对切除的黑色素瘤平均厚度没有影响。
