Department of Research, The Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo University Hospital - Rikshospitalet, NO-0304 Oslo, Norway. E-mail:
Acta Derm Venereol. 2021 Apr 12;101(4):adv00427. doi: 10.2340/00015555-3782.
In Norway, nodular melanoma is the most fatal melanoma subtype and superficial spreading melanoma the most common, indicating diagnostic challenges. The aim of this study was to assess the clinical suspicion sensitivity of nodular melanoma and superficial spreading melanoma, by diagnosing physician, using randomly selected 100 nodular melanomas and 100 superficial spreading melanomas from the Norwegian Melanoma Registry, diagnosed in 2014 to 2015. Information about suggested diagnoses and diagnosing physician was collected from pathology request forms. Suspicion sensitivity was defined as the proportion (%) of cases with "melanoma" as a suggested diagnosis, estimated with 95% confidence interval (95% CI). Most melanomas (74.5%) were diagnosed by non-dermatologists, with a suspicion sensitivity of 23% (95% CI 15-34) for nodular melanoma and 24% (95% CI 16-35) for superficial spreading melanoma. Corresponding estimates for dermatologists were 50% (95% CI 32-68) and 96% (95% CI 80-99), respectively (pinteraction=0.007). The low suspicion sensitivity for both subtypes among non-dermatologists calls for educational efforts.
在挪威，结节性黑色素瘤是最致命的黑色素瘤亚型，而浅表扩散性黑色素瘤是最常见的，这表明诊断存在挑战。本研究的目的是评估诊断医生对结节性黑色素瘤和浅表扩散性黑色素瘤的临床怀疑敏感性，方法是从挪威黑色素瘤登记处 2014 年至 2015 年诊断的 100 例随机选择的结节性黑色素瘤和 100 例浅表扩散性黑色素瘤中选择诊断医师。从病理申请单中收集有关建议诊断和诊断医师的信息。怀疑敏感性定义为建议诊断为“黑色素瘤”的病例比例（%），置信区间（95%CI）为 95%。大多数黑色素瘤（74.5%）由非皮肤科医生诊断，结节性黑色素瘤的怀疑敏感性为 23%（95%CI 15-34），浅表扩散性黑色素瘤的怀疑敏感性为 24%（95%CI 16-35）。皮肤科医生的相应估计值分别为 50%（95%CI 32-68）和 96%（95%CI 80-99）（p 交互=0.007）。非皮肤科医生对这两种亚型的怀疑敏感性均较低，这需要开展教育工作。
