Longo Caterina, Mazzeo Mauro, Raucci Margherita, Cornacchia Luigi, Lai Michela, Bianchi Luca, Peris Ketty, Pampena Riccardo, Pellacani Giovanni
Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy.
Department of Dermatology, Policlinico Tor Vergata, Italy University of Rome "Tor Vergata", Rome, Italy.
J Am Acad Dermatol. 2021 Jun;84(6):1568-1574. doi: 10.1016/j.jaad.2020.07.084. Epub 2020 Jul 27.
There is lack of studies on the diagnostic accuracy of dermoscopy and reflectance confocal microscopy (RCM) for dark pigmented lesions.
To assess the diagnostic accuracy of dermoscopy plus confocal microscopy for melanoma diagnosis of dark pigmented lesions in real life.
Prospective analysis of difficult dark lesions with clinical/dermoscopic suspicion of melanoma referred for RCM for further analysis. The outcome could be excision or dermoscopic digital follow-up.
We included 370 clinically dark lesions from 350 patients (median age, 45 y). Because of the clinical/dermoscopic/RCM approach, we saved 129 of 213 unnecessary biopsies (specificity of 60.6%), with a sensitivity of 98.1% (154/157). The number needed to excise with the addition of RCM was 1.5 for melanoma diagnosis.
Single institution based; Italian population only.
This study showed that RCM coupled with dermoscopy increases the specificity for diagnosing melanoma, and it helps correctly identify benign lesions. Our findings provide the basis for subsequent prospective studies on melanocytic neoplasms belonging to patients in different countries.
关于皮肤镜检查和反射式共聚焦显微镜（RCM）对深色色素沉着病变的诊断准确性的研究较少。
评估在现实生活中，皮肤镜检查加共聚焦显微镜检查对深色色素沉着病变黑色素瘤诊断的准确性。
对临床/皮肤镜检查怀疑为黑色素瘤的疑难深色病变进行前瞻性分析，转诊至RCM进行进一步分析。结果可能是切除或皮肤镜数字随访。
我们纳入了350例患者的370个临床深色病变（中位年龄45岁）。由于采用了临床/皮肤镜检查/RCM方法，我们在213次不必要的活检中避免了129次（特异性为60.6%），敏感性为98.1%（154/157）。对于黑色素瘤诊断，增加RCM后需要切除的病例数为1.5。
基于单一机构；仅为意大利人群。
本研究表明，RCM联合皮肤镜检查可提高黑色素瘤诊断的特异性，并有助于正确识别良性病变。我们的研究结果为后续针对不同国家患者的黑素细胞肿瘤前瞻性研究提供了基础。
