Department of Medical Ultrasound, Clinical Research Center for Interventional Medicine, School of Medicine, Ultrasound Research and Education Institute, Shanghai Skin Disease Hospital and Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China.
Dermatology. 2023;239(4):572-583. doi: 10.1159/000529448. Epub 2023 Feb 2.
The similar visual appearance of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) may cause confusion for diagnosis.
The aim of the study was to investigate the value of ultra-high-frequency ultrasound (uHFUS) in differentiating sBCC from BD.
This prospective study included a pilot cohort of 110 patients (73 BDs and 37 sBCCs) from November 2016 to October 2020 and a validation cohort of 42 patients (30 BDs and 12 sBCCs) from July 2021 to December 2021. Clinical and uHFUS features of pathologically confirmed sBCC and BD were assessed. A predictive model was developed based on the uHFUS features of the pilot cohort. Subsequently, the model was validated and compared with clinical diagnosis in the validation cohort.
uHFUS features with significant differences between sBCC and BD included lesion surface, skin layer involvement, hyperkeratosis, and hyperechoic spots (all p < 0.05). A prediction model based on the above features was established to identify sBCC and BD in the pilot and validation cohorts with areas under the curve (AUC) of 0.908 and 0.923, sensitivity of 82.3% and 83.3%, specificity of 91.9% and 91.7%, and accuracy of 85.5% and 85.7%, respectively, which were significantly higher than those obtained by clinical diagnosis based on photographic pictures of lesions, with the AUC of 0.692, sensitivity of 63.3%, specificity of 75.3%, and accuracy of 66.7% (all p < 0.05).
uHFUS provides detailed internal features of sBCC and BD, which facilitates the differentiation between sBCC and BD, and its diagnostic performance is superior to clinical diagnosis.
浅表基底细胞癌（sBCC）和 Bowen 病（BD）的外观相似，可能导致诊断混淆。
本研究旨在探讨超高频超声（uHFUS）在区分 sBCC 和 BD 中的价值。
本前瞻性研究纳入了 2016 年 11 月至 2020 年 10 月的 110 例患者（73 例 BD 和 37 例 sBCC）的试点队列，以及 2021 年 7 月至 2021 年 12 月的 42 例患者（30 例 BD 和 12 例 sBCC）的验证队列。评估了经病理证实的 sBCC 和 BD 的临床和 uHFUS 特征。基于试点队列的 uHFUS 特征建立了预测模型，然后在验证队列中对其进行验证并与临床诊断进行比较。
sBCC 和 BD 之间有显著差异的 uHFUS 特征包括病变表面、皮肤层受累、角化过度和高回声点（均 p < 0.05）。基于上述特征建立了一个预测模型，用于识别试点和验证队列中的 sBCC 和 BD，曲线下面积（AUC）分别为 0.908 和 0.923，灵敏度分别为 82.3%和 83.3%，特异性分别为 91.9%和 91.7%，准确性分别为 85.5%和 85.7%，均明显高于基于病变照片的临床诊断，AUC 为 0.692，灵敏度为 63.3%，特异性为 75.3%，准确性为 66.7%（均 p < 0.05）。
uHFUS 提供了 sBCC 和 BD 的详细内部特征，有助于区分 sBCC 和 BD，其诊断性能优于临床诊断。
