Kuzmina Natalia, Talme Toomas, Lapins Jan, Emtestam Lennart
Department of Medicine, Section of Dermatology and Venereology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Skin Res Technol. 2005 Aug;11(3):196-200. doi: 10.1111/j.1600-0846.2005.00120.x.
BACKGROUND/AIMS: Although various biophysical properties can be used to distinguish basal cell carcinoma (BCC) tissue from normal skin, none permits typing of the tumour. In this study, we assessed nodular (NBCC) and superficial (SBCC) types of BCC using three different non-invasive instruments and placed special emphasis on their clinical value as diagnostic tools.
We included 35 patients with 35 tumours (15 NBCC and 20 SBCC), which had been diagnosed clinically. All lesions were evaluated preoperatively with an instrument measuring electrical impedance (IMP). Methods for determining transepidermal water loss (TEWL) and laser Doppler (LD) were also used. Measurements were also made in healthy skin on the contralateral side as reference. The diagnosis was confirmed by histological examination.
We found clear differences between the lesions and their reference values, using all three bioengineering techniques for NBCC and SBCC. The biophysical parameters of all types vary with anatomical location. Since most of the NBCC were located on the face and most SBCC on the trunk, their baseline impedance characteristics (i.e., impedance indices magnitude index (MIX) and imaginary part index (IMIX)) differed significantly. We therefore compared delta (a difference between the reference and tumour) MIX and IMIX of NBCC and SBCC instead of the absolute figures. We found no significant differences in TEWL, blood flow and IMP between the two types of BCC and attribute this to biological variation and electromagnetic noise.
As with LD and TEWL, definite differences in IMP were detected between healthy skin and BCC lesions. However, at this stage of development of the bioimpedance technique, we were unable to distinguish between the two types of BCC. An improved IMP device with semi- invasive probes or a more sophisticated type of data analysis may increase the diagnostic usefulness of the IMP method.
背景/目的：尽管多种生物物理特性可用于区分基底细胞癌（BCC）组织与正常皮肤，但尚无一种能对肿瘤进行分型。在本研究中，我们使用三种不同的非侵入性仪器评估了结节型（NBCC）和浅表型（SBCC）基底细胞癌，并特别强调了它们作为诊断工具的临床价值。
我们纳入了35例患有35个肿瘤的患者（15例NBCC和20例SBCC），这些肿瘤均经临床诊断。所有病变术前均使用测量电阻抗（IMP）的仪器进行评估。还采用了测定经表皮水分流失（TEWL）和激光多普勒（LD）的方法。对健康皮肤的对侧也进行了测量作为对照。诊断通过组织学检查得以证实。
使用所有三种生物工程技术评估NBCC和SBCC时，我们发现病变与其对照值之间存在明显差异。所有类型的生物物理参数随解剖位置而变化。由于大多数NBCC位于面部，大多数SBCC位于躯干，它们的基线阻抗特征（即阻抗指数幅度指数（MIX）和虚部指数（IMIX））存在显著差异。因此，我们比较了NBCC和SBCC的增量（对照与肿瘤之间的差值）MIX和IMIX，而非绝对值。我们发现两种类型的BCC在TEWL、血流和IMP方面无显著差异，将此归因于生物学变异和电磁噪声。
与LD和TEWL一样，在健康皮肤和BCC病变之间检测到IMP存在明确差异。然而，在生物阻抗技术的这一发展阶段，我们无法区分这两种类型的BCC。一种改进的带有半侵入性探头的IMP设备或更复杂的数据分析类型可能会提高IMP方法的诊断效用。
