Mogensen Mette, Joergensen Thomas Martini, Nürnberg Birgit Meincke, Morsy Hanan Ahmad, Thomsen Jakob B, Thrane Lars, Jemec Gregor B E
Department of Dermatology, Roskilde Hospital, Faculty of Health Sciences, University of Copenhagen, Roskilde, Denmark.
Dermatol Surg. 2009 Jun;35(6):965-72. doi: 10.1111/j.1524-4725.2009.01164.x. Epub 2009 Apr 8.
Optical coherence tomography (OCT) is an optical imaging technique that may be useful in diagnosis of non-melanoma skin cancer (NMSC).
To describe OCT features in NMSC such as actinic keratosis (AK) and basal cell carcinoma (BCC) and in benign lesions and to assess the diagnostic accuracy of OCT in differentiating NMSC from benign lesions and normal skin.
OCT and polarization-sensitive (PS) OCT from 104 patients were studied. Observer-blinded evaluation of OCT images from 64 BCCs, 1 baso-squamous carcinoma, 39 AKs, two malignant melanomas, nine benign lesions, and 105 OCT images from perilesional skin was performed; 50 OCT images of NMSC and 50 PS-OCT images of normal skin were evaluated twice.
Sensitivity was 79% to 94% and specificity 85% to 96% in differentiating normal skin from lesions. Important features were absence of well-defined layering in OCT and PS-OCT images and dark lobules in BCC. Discrimination of AK from BCC had an error rate of 50% to 52%.
OCT features in NMSC are identified, but AK and BCC cannot be differentiated. OCT diagnosis is less accurate than clinical diagnosis, but high accuracy in distinguishing lesions from normal skin, crucial for delineating tumor borders, was obtained.
光学相干断层扫描（OCT）是一种光学成像技术，可能有助于非黑色素瘤皮肤癌（NMSC）的诊断。
描述NMSC（如光化性角化病（AK）和基底细胞癌（BCC））以及良性病变中的OCT特征，并评估OCT在鉴别NMSC与良性病变及正常皮肤方面的诊断准确性。
对104例患者的OCT和偏振敏感（PS）OCT进行了研究。对64例BCC、1例基底鳞状细胞癌、39例AK、2例恶性黑色素瘤、9例良性病变的OCT图像进行了观察者盲法评估，并对病变周围皮肤的105张OCT图像进行了评估；对50张NMSC的OCT图像和50张正常皮肤的PS-OCT图像进行了两次评估。
在区分正常皮肤与病变时，敏感性为79%至94%，特异性为85%至96%。重要特征包括OCT和PS-OCT图像中缺乏明确的分层以及BCC中的暗小叶。AK与BCC的鉴别错误率为50%至52%。
已确定NMSC中的OCT特征，但无法区分AK和BCC。OCT诊断不如临床诊断准确，但在区分病变与正常皮肤方面具有较高的准确性，这对于勾勒肿瘤边界至关重要。
