Lupu Mihai, Popa Iris Maria, Voiculescu Vlad Mihai, Caruntu Ana, Caruntu Constantin
Department of Dermatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Plastic and Reconstructive Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, 041915 Bucharest, Romania.
J Clin Med. 2019 Sep 13;8(9):1462. doi: 10.3390/jcm8091462.
Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies' methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87-0.95; I= 85.27%) and 0.93 (95% CI, 0.85-0.97; I= 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8-31.37; I= 91.01%) and 0.08 (95% CI, 0.05-0.14; I= 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73-397.02; I=71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC.
基底细胞癌（BCC）是全球最常见的癌症，其发病率持续上升。早期诊断和治疗可显著降低患者发病率和医疗成本。反射式共聚焦显微镜（RCM）在非黑色素瘤皮肤癌诊断中的价值仍存在争议。本系统评价和荟萃分析旨在评估RCM对原发性BCC的诊断准确性。检索了截至2019年7月5日的PubMed、谷歌学术、Scopus和科学网数据库，以收集有关通过RCM诊断原发性BCC的文章。采用QUADAS - 2工具评估研究的方法学质量。使用Stata 13.0、RevMan 5.0和MetaDisc 1.4软件进行荟萃分析。我们纳入了15项研究，共4163个病变。合并敏感度和特异度分别为0.92（95%CI，0.87 - 0.95；I = 85.27%）和0.93（95%CI，0.85 - 0.97；I = 94.61%），合并阳性和阴性似然比分别为13.51（95%CI，5.8 - 31.37；I = 91.01%）和0.08（95%CI，0.05 - 0.14；I = 84.83%），合并诊断比值比为160.31（95%CI，64.73 - 397.02；I = 71%）。尽管存在异质性和偏倚风险，但本研究表明，RCM凭借其高敏感度和特异度，可能对原发性BCC的诊断产生显著临床影响。
