Skin Cancer Unit Arcispedale Santa Maria Nuova IRCCS Reggio Emilia, Italy -
G Ital Dermatol Venereol. 2014 Apr;149(2):161-6.
Accuracy in melanoma detection is important to recognize early curable melanomas and to minimize the unnecessary excision of benign lesions. The aim of this paper was to evaluate melanoma screening accuracy of Italian pigmented lesion clinics in terms of number needed to excise (NNE), melanoma thickness, and number of melanomas diagnosed during patient follow-up.
Information on all skin tumors excised in 2011 were extracted from the databases of the participating centers. Information whether the lesion was excised at the baseline examination or during patient follow-up was recorded, as well as the overall number of patients examined in each center in 2011.
After e-mail solicitation, 22 of 40 centers agreed to participate. A total of 8229 excised lesions were collected. The overall number of examined patients was 86.564, thus 9.5% of screened patients had a lesion removed. Of the excised lesions, 866 were diagnosed as melanoma (1% of examined patients) and 5311 (88.9%) were melanocytic nevi. Three NNE were calculated giving values of 7.9 excised lesions to find 1 melanoma, 7.1 melanocytic lesions to find 1 melanoma, and 3.7 lesions to find 1 skin malignancy. The median melanoma thickness was 0.6 mm, with only 15.1% of melanomas ≥ 1 mm of thickness. Melanomas detected over time were 96 (11.1%; mean thickness, 0.3 mm), with 15.6% of lesions excised after short-term follow-up and 84.4% after long-term follow-up.
The NNE values comparable to those achieved in specialized clinical settings and the high number of early melanomas diagnosed at the baseline examination or during patient follow-up indicate a high level of accuracy in melanoma screening achieved by Italian pigmented lesion clinics.
提高黑素瘤检测的准确性对于识别早期可治愈的黑素瘤并减少良性病变的不必要切除至关重要。本文旨在评估意大利色素性病变诊所的黑素瘤筛查准确性，包括需要切除的数量（NNE）、黑素瘤厚度和患者随访期间诊断的黑素瘤数量。
从参与中心的数据库中提取 2011 年切除的所有皮肤肿瘤信息。记录病变是在基线检查时切除还是在患者随访期间切除，以及每个中心 2011 年检查的总患者人数。
在电子邮件征求意见后，40 个中心中有 22 个同意参加。共收集了 8229 个切除的病变。总的检查患者人数为 86564 人，因此 9.5%的筛查患者切除了病变。在切除的病变中，866 例被诊断为黑素瘤（占检查患者的 1%），5311 例（88.9%）为黑素细胞痣。计算了三个 NNE，值分别为发现 1 个黑素瘤需要切除 7.9 个病变，发现 1 个黑素瘤需要切除 7.1 个黑素细胞病变，发现 1 个皮肤恶性肿瘤需要切除 3.7 个病变。黑素瘤的中位厚度为 0.6 毫米，只有 15.1%的黑素瘤厚度≥1 毫米。随着时间的推移发现的黑素瘤为 96 例（11.1%；平均厚度为 0.3 毫米），其中 15.6%在短期随访后切除，84.4%在长期随访后切除。
与专门的临床环境中获得的 NNE 值以及在基线检查或患者随访期间诊断出的大量早期黑素瘤相比，意大利色素性病变诊所的黑素瘤筛查准确性较高。
