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通过色素性皮肤病变的胶带剥离检测皮肤恶性黑素瘤——系统评价。

Detection of cutaneous malignant melanoma by tape stripping of pigmented skin lesions - A systematic review.

机构信息

Department of Dermatology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

Skin Res Technol. 2023 Mar;29(3):e13286. doi: 10.1111/srt.13286.

Abstract

BACKGROUND

Cutaneous malignant melanoma (MM) is potentially aggressive, and numerous clinically suspicious pigmented skin lesions are excised, causing unnecessary mutilation for patients at high healthcare costs, but without histopathological evidence of MM. The high number of excisions may be lowered by using more accurate diagnostics. Tape stripping (TS) of clinically suspicious lesions is a non-invasive diagnostic test of MM that can potentially lower the number needed to biopsy/excise.

MATERIALS AND METHODS

The aim is to determine the diagnostic accuracy of TS in detecting MM in clinically suspicious pigmented skin lesions. This systematic review following PRISMA guidelines searched PubMed, Web of Science, and Embase (September 2022) using melanoma combined with tape stripping, adhesive patch(es), pigmented lesion assay, or epidermal genetic information retrieval.

RESULTS

Ten studies were included. Sensitivity ranged from 68.8% (95% confidence interval [CI] 51.5, 82.1) to 100% (95% CI 91.0, 100). Specificity ranged from 69.1% (95% CI 63.8, 74.0) to 100% (95% CI 78.5, 100). A pooled analysis of five studies testing the RNA markers LINC00518 and PRAME found a sensitivity of 86.9% (95% CI 81.7, 90.8) and a specificity of 82.4% (95% CI 80.8, 83.9).

CONCLUSION

Overall quality of studies was low, and the reliability of sensitivity and specificity is questionable. However, TS may supplement well-established diagnostic methods as pooled analysis of five studies indicates a moderate sensitivity. Future studies are needed to obtain more reliable data as independent studies with no conflict of interest.

摘要

背景

皮肤恶性黑色素瘤(MM)具有潜在侵袭性,大量临床可疑色素性皮肤病变被切除,给患者带来不必要的创伤,同时增加了医疗成本,但没有 MM 的组织病理学证据。通过使用更准确的诊断方法,可以降低切除的数量。临床可疑病变的胶带剥离(TS)是一种非侵入性的 MM 诊断测试,可能会降低活检/切除的数量。

材料和方法

本研究旨在确定 TS 在检测临床可疑色素性皮肤病变中的 MM 诊断准确性。本研究按照 PRISMA 指南,系统检索了 PubMed、Web of Science 和 Embase(2022 年 9 月),检索词包括黑色素瘤与胶带剥离、粘性贴片、色素性病变检测或表皮遗传信息检索。

结果

共纳入 10 项研究。敏感性范围为 68.8%(95%可信区间 [CI] 51.5,82.1)至 100%(95% CI 91.0,100)。特异性范围为 69.1%(95% CI 63.8,74.0)至 100%(95% CI 78.5,100)。五项研究中检测 LINC00518 和 PRAME RNA 标志物的综合分析显示,敏感性为 86.9%(95% CI 81.7,90.8),特异性为 82.4%(95% CI 80.8,83.9)。

结论

研究的总体质量较低,敏感性和特异性的可靠性值得怀疑。然而,TS 可能会补充现有的诊断方法,因为五项研究的综合分析表明其具有中等敏感性。需要开展进一步的研究,以获得更可靠的数据,且这些研究应无利益冲突。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32ec/10155806/f0d5c89ced72/SRT-29-e13286-g001.jpg

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