基底细胞癌的皮肤镜表现与病理类型的相关性研究
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摘要
目的探讨研究皮肤镜检查在临床诊断基底细胞癌中的意义,研究基底细胞癌的皮肤镜下分型与其病理类型之间的关系。方法收集2015年7月至2018年6月收治的临床诊断考虑为基底细胞癌的77例患者病例资料,对其皮肤镜检查结果及病理确诊分型结果进行统计分析。结果 (1)与病理诊断比较,皮肤镜诊断基底细胞癌的灵敏度为98.31%,特异度为83.33%,阳性率预测值为95.08%,误诊率16.67%,漏诊率1.69%,总符合率为94.81%,正确指数(Youden指数)为0.82,Kappa值为0.849;(2)不同的皮肤镜分型其病理表现不同,差异具有统计学意义(P<0.05),皮肤镜下的四组分型两两比较,任意两组间比较,差异具有统计学意义(P<0.05)。结论 (1)皮肤镜检查在临床诊断基底细胞癌中具有重要意义;(2)不同基底细胞癌的皮肤镜表现对应的常见病理类型不同。
Objective To explore the significance of dermoscopy in clinical diagnosis of basal cell carcinoma, and study the relationship between the dermoscopic classification of basal cell carcinoma and its pathological types. Methods Data of 77 patients with basal cell carcinoma were collected from July 2015 to June 2018. The results of dermoscopy and pathological diagnosis and classification were analyzed. Results(1)Compared with pathological diagnosis, the sensitivity, specificity, positive predictive value, misdiagnosis rate and missed diagnosis rate of dermoscopy for basal cell carcinoma were 98.31%, 83.33%, 95.08%, 16.67%, 1.69%, 94.81%, 0.82 and 0.849 respectively;(2)The pathological manifestations of different dermoscopic types were different, and the difference was statistically significant(P<0.05). The two comparisons of the four groups under dermoscope showed significant difference between any two groups(P<0.05). Conclusion(1)Dermatoscope is of great importance in the diagnosis of basal cell carcinoma;(2)The dermoscopic manifestations of different basal cell carcinomas correspond to different common pathological types.
Objective To explore the significance of dermoscopy in clinical diagnosis of basal cell carcinoma, and study the relationship between the dermoscopic classification of basal cell carcinoma and its pathological types. Methods Data of 77 patients with basal cell carcinoma were collected from July 2015 to June 2018. The results of dermoscopy and pathological diagnosis and classification were analyzed. Results(1)Compared with pathological diagnosis, the sensitivity, specificity, positive predictive value, misdiagnosis rate and missed diagnosis rate of dermoscopy for basal cell carcinoma were 98.31%, 83.33%, 95.08%, 16.67%, 1.69%, 94.81%, 0.82 and 0.849 respectively;(2)The pathological manifestations of different dermoscopic types were different, and the difference was statistically significant(P<0.05). The two comparisons of the four groups under dermoscope showed significant difference between any two groups(P<0.05). Conclusion(1)Dermatoscope is of great importance in the diagnosis of basal cell carcinoma;(2)The dermoscopic manifestations of different basal cell carcinomas correspond to different common pathological types.
引文
[1]Li SY,Qureshi AA,Li WQ.Basal cell carcinoma in organ transplant recipients[J].Br J Dermatol,2016,174(1):16-17.
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[3]赵森,李丽,郭书萍.基底细胞癌的皮肤镜表现与病理类型的相关性研究[J].临床医药文献杂志,2018,5(26):17-18.
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[5]廖晓容.基底细胞癌的治疗进展[J].皮肤病与性病,2017,1(39):31-32.
[6]刘子莲,张倩,吴雯婷,等.518例恶性皮肤肿瘤及癌前病变的回顾性分析[J].首都医科大学学报,2018,4(39):601-606.
[7]Corona R,Dogliotti E,D Errico M,et al.Risk factors for basal cell carcinoma in a Mediterranean population:role of recreational sun exposure early in life[J].Arch Dermatol,2007,137(9):1126-1168.
[8]Godoy CAP,Neta ALO,Leao SSS,et al.Evaluation of surgical margins according to the histological type of basal cell carcinoma[J].Anais Brasileiros De Dermatologia,2017,92(2):226-230.
[9]Lallas A,Apalla Z,Ioannides D,et al.Dermoscopy in the diagnosis and management of basal cell carcinoma[J].Future Oncology,2015,11(22):2975-2984.
[10]赵辩.中国临床皮肤病学[M].2版.南京:江苏科学技术出版社,2017:1524-1526.
[11]李薇薇,涂平,杨淑霞,等.皮肤镜对基底细胞癌鉴别诊断价值的初步研究[J].中华皮肤科杂志,2013,46(7):480-484.
[12]何沅莉,单葵.基底细胞癌153例临床病理特点回顾性分析[J].现代医药卫生,2018,34(9):1313-1315.
[13]Huseinelahmed H,Fernandezpugnaire MA.Dermatoscopy-guided therapy of pigmented basal cell carcinoma with imiquimod[J].Anais Brasileiros De Dermatologia,2016,91(6):764-769.
[2]H Huseinelahmed.Sclerodermiform basal cell carcinoma:how much can we rely on dermatoscopy to differentiate from non-aggressive basal cell carcinomas?Analysis of 1256 cases[J].Anais Brasileiros De Dermatologia,2018,93(2):229-232.
[3]赵森,李丽,郭书萍.基底细胞癌的皮肤镜表现与病理类型的相关性研究[J].临床医药文献杂志,2018,5(26):17-18.
[4]Mckee PH,Calonje E,Granter SR.皮肤病理学:与临床的联系[M].4版.朱学骏,孙建方,译.北京:北京大学医学出版社,2017:1167-1184
[5]廖晓容.基底细胞癌的治疗进展[J].皮肤病与性病,2017,1(39):31-32.
[6]刘子莲,张倩,吴雯婷,等.518例恶性皮肤肿瘤及癌前病变的回顾性分析[J].首都医科大学学报,2018,4(39):601-606.
[7]Corona R,Dogliotti E,D Errico M,et al.Risk factors for basal cell carcinoma in a Mediterranean population:role of recreational sun exposure early in life[J].Arch Dermatol,2007,137(9):1126-1168.
[8]Godoy CAP,Neta ALO,Leao SSS,et al.Evaluation of surgical margins according to the histological type of basal cell carcinoma[J].Anais Brasileiros De Dermatologia,2017,92(2):226-230.
[9]Lallas A,Apalla Z,Ioannides D,et al.Dermoscopy in the diagnosis and management of basal cell carcinoma[J].Future Oncology,2015,11(22):2975-2984.
[10]赵辩.中国临床皮肤病学[M].2版.南京:江苏科学技术出版社,2017:1524-1526.
[11]李薇薇,涂平,杨淑霞,等.皮肤镜对基底细胞癌鉴别诊断价值的初步研究[J].中华皮肤科杂志,2013,46(7):480-484.
[12]何沅莉,单葵.基底细胞癌153例临床病理特点回顾性分析[J].现代医药卫生,2018,34(9):1313-1315.
[13]Huseinelahmed H,Fernandezpugnaire MA.Dermatoscopy-guided therapy of pigmented basal cell carcinoma with imiquimod[J].Anais Brasileiros De Dermatologia,2016,91(6):764-769.