皮肤镜联合RCM在皮肤黑素瘤诊断中的价值

The Application of Dermoscopy Combined with RCM in the Diagnosis of Melanoma

目的探讨皮肤镜联合反射式共聚焦激光扫描显微镜(RCM)在皮肤黑素瘤诊断中的价值。方法选取2020年1月—2023年1月就诊于本科,初诊考虑黑素瘤的患者进行皮肤镜及RCM检查,并且1周内行组织病理学检查明确诊断。分别评估皮肤镜、RCM、皮肤镜联合RCM与组织病理诊断之间的一致性,比较各方法的诊断价值。结果共纳入研究对象78例。以病理诊断为金标准,皮肤镜诊断黑素瘤的灵敏度为93.33%、特异度为81.82%,RCM诊断黑素瘤的灵敏度为75.56%、特异度为93.94%,皮肤镜联合RCM的灵敏度为95.56%、特异度为84.85%,皮肤镜+RCM的诊断价值优于皮肤镜(Z=2.06,P=0.04)和RCM(Z=3.00,P=0.003)。结论皮肤镜联合RCM在皮肤黑素瘤诊断中的价值优于单一影像技术。

Objective To investigate the value of dermoscopy combined with reflectance confocal microscopy(RCM)in the diagnosis of melanoma.Methods Patients presenting to our department from January 2020 to January 2023,with suspected melanoma,underwent dermoscopy and RCM examinations.Tissue pathology examination was performed within one week to confirm the diagnosis.The consistency between dermoscopy,RCM,dermoscopy combined with RCM,and histopathology was evaluated,and the diagnostic value of each method was compared.Results A total of 78 cases were included.Using histopathological diagnosis as the gold standard,the sensitivity and specificity of dermoscopy in diagnosing melanoma were 93.33%and 81.82%,respectively.The sensitivity and specificity of RCM were 75.56%and 93.94%,respectively.The sensitivity and specificity of dermoscopy combined with RCM were 95.56%and 84.85%,respectively.The diagnostic value of dermoscopy combined with RCM was superior to dermoscopy(Z=2.06,P=0.04)and RCM(Z=3.00,P=0.003).Conclusion Dermoscopy combined with RCM has a higher diagnostic value in melanoma compared to individual imaging techniques.