光学相干断层扫描在诊断局部治疗后复发性或残留基底细胞癌中的作用：一项诊断队列研究。
Optical coherence tomography for diagnosing recurrent or residual basal cell carcinoma after topical treatment: A diagnostic cohort study.
机构信息
Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
出版信息
J Am Acad Dermatol. 2023 Oct;89(4):728-733. doi: 10.1016/j.jaad.2023.06.033. Epub 2023 Jun 28.
BACKGROUND
Recurrent/residual basal cell carcinoma (BCC) after topical treatment may not be visible during clinical and dermatoscopic examination (CDE). Optical coherence tomography (OCT) may detect these subclinical recurrences or residues.
OBJECTIVE
To compare the diagnostic accuracy of CDE with that of CDE combined with OCT (CDE-OCT) for detecting recurrent/residual BCC after topical treatment of superficial BCC.
METHODS
In this diagnostic cohort study, the suspicion level for recurrence or residue was recorded on a 5-point confidence scale. All patients with high suspicion of recurrence or residue based on CDE and/or CDE-OCT were referred for punch biopsy. Patients with a low suspicion on CDE and CDE-OCT were asked to (voluntarily) undergo a control biopsy. Histopathologic results of the biopsy were used for verification of CDE and CDE-OCT diagnoses (gold standard).
RESULTS
This study included 100 patients. A histopathologic recurrent/residual BCC was found in 20 patients. For recurrence or residue detection, sensitivity was 100% (20 of 20) for CDE-OCT and 60% (12 of 20) for CDE (P = .005) and specificity was 95% for CDE-OCT and 96.3% for CDE (P = .317). The area under the curve for CDE-OCT (0.98) was significantly higher than that for CDE (0.77) (P = .001).
LIMITATIONS
Results are based on 2 OCT assessors.
CONCLUSION
Compared with CDE alone, CDE-OCT results in a significantly higher ability to detect recurrent/residual BCCs after topical treatment.
背景
局部治疗后复发/残留的基底细胞癌（BCC）在临床和皮肤镜检查（CDE）中可能不可见。光学相干断层扫描（OCT）可检测这些亚临床复发或残留。
目的
比较 CDE 与 CDE 联合 OCT（CDE-OCT）检测浅表 BCC 局部治疗后复发/残留 BCC 的诊断准确性。
方法
在这项诊断性队列研究中，根据 5 分置信度量表记录复发或残留的可疑程度。所有 CDE 和/或 CDE-OCT 高度怀疑复发或残留的患者均被转诊进行皮肤活检。CDE 和 CDE-OCT 低度怀疑复发或残留的患者被要求（自愿）进行对照活检。活检的组织病理学结果用于验证 CDE 和 CDE-OCT 诊断（金标准）。
结果
本研究纳入了 100 例患者。20 例患者存在组织病理学复发/残留 BCC。对于复发或残留的检测，CDE-OCT 的敏感性为 100%（20/20），CDE 的敏感性为 60%（12/20）（P=0.005），特异性分别为 95%和 96.3%（P=0.317）。CDE-OCT 的曲线下面积（0.98）明显高于 CDE（0.77）（P=0.001）。
局限性
结果基于 2 名 OCT 评估者。
结论
与单独的 CDE 相比，CDE-OCT 可显著提高检测局部治疗后复发/残留 BCC 的能力。
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