Jayasinghe Dilki, Naranpanawa Nathasha, Ashley Daniel Paul, Ingvar Åsa, Betz-Stablein Brigid, Soyer H Peter, Janda Monika
Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Queensland, Australia.
Dermatol Pract Concept. 2024 Oct 30;14(4):e2024223. doi: 10.5826/dpc.1404a223.
Having many melanocytic nevi on the skin is a risk factor for melanoma. However, the reproducibility of nevus counts in previous studies is limited due to high inter- and intraobserver variation. Despite the introduction of a protocol for counting and reporting of nevi in 1990 by the International Agency for Research on Cancer (IARC), significant variations in nevus counting methods persist across studies.
We sought to review the variations in nevus counting and reporting methods, adherence and deviations from the IARC protocol, and the reproducibility of nevus counting studies.
A systematic search of Embase, PubMed, and Web of Science was conducted. The review was limited to nevus (>2 mm) counting studies of general population adults conducted between 2000 and 2022 and studies using skilled examiners.
Out of the eight studies which were eligible for inclusion, none followed the IARC protocol. Three studies used a predefined criterion to count nevi. Five studies provided training for their observers. Three studies assessed the inter- or intraobserver variation using the correlation coefficient (>0.75), and three studies attempted to verify the validity and the reproducibility of the counts. There was little to no agreement in nevus counting and reporting procedures in the reviewed studies, and most studies did not report their procedures adequately.
This review highlights the need for an easily accessible and feasible protocol for the identification, counting, and reporting of nevi, which also considers nevus counting from total-body imaging and automated nevus counts since these technologies are expected to become widely available for future studies.
皮肤上有许多黑素细胞痣是黑色素瘤的一个危险因素。然而，由于观察者之间和观察者内部的差异较大，以往研究中痣计数的可重复性有限。尽管国际癌症研究机构（IARC）在1990年推出了一项痣计数和报告方案，但各研究之间痣计数方法仍存在显著差异。
我们旨在回顾痣计数和报告方法的差异、对IARC方案的遵循情况和偏差，以及痣计数研究的可重复性。
对Embase、PubMed和科学网进行了系统检索。该综述仅限于2000年至2022年间对成年普通人群进行的痣（>2mm）计数研究以及使用熟练检查人员的研究。
在八项符合纳入标准的研究中，没有一项遵循IARC方案。三项研究使用预定义标准计数痣。五项研究为其观察者提供了培训。三项研究使用相关系数（>0.75）评估观察者间或观察者内的差异，三项研究试图验证计数的有效性和可重复性。在所审查的研究中，痣计数和报告程序几乎没有一致性，且大多数研究未充分报告其程序。
本综述强调需要一个易于获取且可行的痣识别、计数和报告方案，该方案还应考虑从全身成像中进行痣计数以及自动痣计数，因为预计这些技术将在未来研究中广泛应用。
