多光束光学相干断层扫描评估基底细胞癌的评分系统。
Assessment of a scoring system for Basal Cell Carcinoma with multi-beam optical coherence tomography.
机构信息
Charité-Universitätsmedizin Berlin, Skin Cancer Centre Charité, Department of Dermatology, Venereology and Allergology, Charité Campus Mitte, Berlin, Germany.
出版信息
J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1562-9. doi: 10.1111/jdv.12935. Epub 2015 Jan 30.
BACKGROUND
Multi-beam optical coherence tomography (OCT) is a novel method of non-invasive skin imaging allowing the evaluation of tissue at high level of lateral and axial resolution. It permits the horizontal and vertical evaluation of the extent of diseases.
OBJECTIVE
Herein, we aimed to validate diagnosing basal cell carcinoma (BCC) by OCT using a newly developed scoring system ('Berlin Score'-BS). This was based on the predetermined criteria such as dark border underneath the tumour and ovoid structures. Their frequency and distribution in subtypes of BCC were evaluated.
METHODS
The study was conducted in two phases, in which the experience of examiner differed. A total of 127 BCC and 50 other skin diseases were examined. In phase one, students performed the evaluation of skin lesions using the BS, while in phase two an expert performed the scoring in a different subset of patients.
RESULTS
Application of BS by students revealed sensitivity and specificity of 92.8% (95% CI 85.4-96.8) and 24.1% (95% CI 11.0-43.4) when reaching the lower threshold BS≥8. The most common BCC subtypes were superficial (28.7%) and nodular (22.6%) BCC. Second phase was carried out to verify collected data by a dermatological specialist and expert in using OCT. Increased sensitivity and specificity for OCT amounted to 96.6% (95% CI 80.4-99.8) and 75.2% (95% CI 52.5-90.9). Thereby 88% of all diagnoses were correctly classified confirmed by histopathology.
CONCLUSION
Multi-beam optical coherence tomography revealed to be a fast and promising device for assessing lesions by means of BS. Both students, who benefit from practice in handling OCT, and experts are able to perform this procedure. However, experience and training in the interpretation markedly increased sensitivity and specificity of the BS in our study. Moreover, redefinition and refining of the criteria seems necessary and may further increase the diagnostic value of OCT for NMSC.
背景
多光束光学相干断层扫描（OCT）是一种新型的非侵入性皮肤成像方法，可实现高横向和轴向分辨率的组织评估。它可以水平和垂直评估疾病的程度。
目的
本文旨在使用新开发的评分系统（“柏林评分”-BS）通过 OCT 诊断基底细胞癌（BCC）。该评分系统基于肿瘤下方的暗边界和卵圆形结构等预定标准。评估了它们在 BCC 各亚型中的频率和分布。
方法
该研究分两个阶段进行，其中检查者的经验不同。共检查了 127 例 BCC 和 50 例其他皮肤疾病。在第一阶段，学生使用 BS 评估皮肤病变，而在第二阶段，专家在另一组患者中进行评分。
结果
学生应用 BS 的结果显示，当达到 BS≥8 的较低阈值时，敏感性和特异性分别为 92.8%（95%CI 85.4-96.8）和 24.1%（95%CI 11.0-43.4）。最常见的 BCC 亚型是浅表型（28.7%）和结节型（22.6%）BCC。第二阶段是为了验证由皮肤科专家和 OCT 使用专家收集的数据。OCT 的敏感性和特异性分别提高到 96.6%（95%CI 80.4-99.8）和 75.2%（95%CI 52.5-90.9）。通过组织病理学证实，88%的所有诊断均正确分类。
结论
多光束光学相干断层扫描已成为一种快速、有前途的评估病变的设备，使用 BS。受益于 OCT 操作实践的学生和专家都能够进行此操作。然而，在我们的研究中，解释经验和培训显著提高了 BS 的敏感性和特异性。此外，对标准进行重新定义和细化似乎是必要的，这可能会进一步提高 OCT 对非黑色素瘤皮肤癌的诊断价值。
Zotero 插件