Podolec Katarzyna, Pirowska Magdalena, Dyduch Grzegorz, Wojas-Pelc Anna
Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland.
Department of Pathology, Jagiellonian University Medical College, Krakow, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):531-534. doi: 10.5114/ada.2019.82742. Epub 2019 Feb 5.
The incidence and mortality of melanoma are rising rapidly. Despite ongoing research and the introduction of new therapeutic methods, advanced melanoma is still considered incurable. Early detection and surgical excision of the tumor increases patients' survival. Since the diagnostic protocol includes surgical excision of all suspicious lesions, it is burdened with a high rate of unnecessary excisions that cause unwanted scarring. This is why the development of accurate diagnostic techniques is crucial. The most common diagnostic tool in early diagnosis of cutaneous melanoma is dermoscopy, though there are emerging new techniques, such as reflectance confocal microscopy and optical coherence tomography.
To evaluate diagnostic accuracy of reflectance confocal microscopy as a secondary examination in melanocytic lesions previously diagnosed as melanomas by means of dermoscopy.
Forty-six melanocytic lesions presenting dermoscopic features of cutaneous malignant melanoma were examined by means of reflectance confocal microscopy.
The RCM evaluation showed sensitivity at the level of 100% and specificity at 62%.
It can be estimated that double evaluation of melanocytic lesions by dermoscopy and reflectance confocal microscopy may allow up to 62% of unnecessary excisions to be avoided.
黑色素瘤的发病率和死亡率正在迅速上升。尽管持续开展研究并引入了新的治疗方法，但晚期黑色素瘤仍被认为无法治愈。早期发现并手术切除肿瘤可提高患者生存率。由于诊断方案包括对所有可疑病变进行手术切除，因此存在大量不必要的切除，导致不必要的瘢痕形成。这就是为什么开发准确的诊断技术至关重要。皮肤黑色素瘤早期诊断中最常用的诊断工具是皮肤镜检查，不过也有一些新兴技术，如反射式共聚焦显微镜和光学相干断层扫描。
评估反射式共聚焦显微镜作为对先前经皮肤镜检查诊断为黑色素瘤的黑素细胞性病变的二次检查的诊断准确性。
对46例具有皮肤恶性黑色素瘤皮肤镜特征的黑素细胞性病变进行反射式共聚焦显微镜检查。
反射式共聚焦显微镜评估显示敏感性为100%，特异性为62%。
据估计，通过皮肤镜检查和反射式共聚焦显微镜对黑素细胞性病变进行双重评估可避免高达62%的不必要切除。
