Argenziano G, Fabbrocini G, Carli P, De Giorgi V, Sammarco E, Delfino M
Department of Dermatology, Federico II University of Naples, Italy.
Arch Dermatol. 1998 Dec;134(12):1563-70. doi: 10.1001/archderm.134.12.1563.
To compare the reliability of a new 7-point checklist based on simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard pattern analysis for the diagnosis of clinically doubtful melanocytic skin lesions.
In a blind study, ELM images of 342 histologically proven melanocytic skin lesions were evaluated for the presence of 7 standard criteria that we called the "ELM 7-point checklist." For each lesion, "overall" and "ABCD scored" diagnoses were recorded. From a training set of 57 melanomas and 139 atypical nonmelanomas, odds ratios were calculated to create a simple diagnostic model based on identification of major and minor criteria for the "7-point scored" diagnosis. A test set of 60 melanomas and 86 atypical nonmelanomas was used for model validation and was then presented to 2 less experienced ELM observers, who recorded the ABCD and 7-point scored diagnoses.
University medical centers.
A sample of patients with excised melanocytic lesions.
Sensitivity, specificity, and accuracy of the models for diagnosing melanoma.
From the total combined sets, the 7-point checklist gave a sensitivity of 95% and a sepcificity of 75% compared with 85% sensitivity and 66% specificity using the ABCD rule and 91% sensitivity and 90% specificity using standard pattern analysis (overall ELM diagnosis). Compared with the ABCD rule, the 7-point method allowed less experienced observers to obtain higher diagnostic accuracy values.
The ELM 7-point checklist provides a simplification of standard pattern analysis because of the low number of features to identify and the scoring diagnostic system. As with the ABCD rule, it can be easily learned and easily applied and has proven to be reliable in diagnosing melanoma.
比较基于简化表皮透光显微镜（ELM）模式分析的新7分检查表与皮肤镜检查的ABCD规则及标准模式分析在诊断临床可疑黑素细胞性皮肤病变方面的可靠性。
在一项盲法研究中，对342例经组织学证实的黑素细胞性皮肤病变的ELM图像进行评估，以确定7项标准标准的存在，我们将其称为“ELM 7分检查表”。对每个病变记录“总体”和“ABCD评分”诊断。从57例黑色素瘤和139例非典型非黑色素瘤的训练集中，计算优势比以创建基于识别“7分评分”诊断的主要和次要标准的简单诊断模型。使用60例黑色素瘤和86例非典型非黑色素瘤的测试集进行模型验证，然后将其呈现给2名经验较少的ELM观察者，他们记录ABCD和7分评分诊断。
大学医学中心。
切除黑素细胞性病变的患者样本。
诊断黑色素瘤模型的敏感性、特异性和准确性。
在总组合集中，7分检查表的敏感性为95%，特异性为75%，而使用ABCD规则时敏感性为85%，特异性为66%，使用标准模式分析（总体ELM诊断）时敏感性为91%，特异性为90%。与ABCD规则相比，7分法使经验较少的观察者能够获得更高的诊断准确性值。
ELM 7分检查表由于需要识别的特征数量少且采用评分诊断系统，简化了标准模式分析。与ABCD规则一样，它易于学习和应用，并且已被证明在诊断黑色素瘤方面是可靠的。
