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The diagnostic accuracy of dermoscopy for basal cell carcinoma: A systematic review and meta-analysis
Journal of the American Academy of Dermatology ( IF 13.8 ) Pub Date : 2018-12-21 , DOI: 10.1016/j.jaad.2018.12.026
Ofer Reiter , Ilit Mimouni , Michael Gdalevich , Ashfaq A. Marghoob , Assi Levi , Emmilia Hodak , Yael Anne Leshem

Background

Dermoscopy is a noninvasive technique for the diagnosis of skin lesions. Its accuracy for basal cell carcinoma (BCC) has not been systematically studied.

Objective

We sought to systematically investigate the accuracy of dermoscopy for the diagnosis of BCC compared with examination with the naked eye.

Methods

A systematic review of studies reporting the accuracy of naked eye examination and dermoscopy for the diagnosis of BCC was conducted. A meta-analysis for sensitivity and specificity was performed using a bivariate mixed-effects logistic regression modeling framework.

Results

Seventeen studies were identified. The pooled sensitivity and specificity of dermoscopy for the diagnosis of BCC were 91.2% and 95%, respectively. In studies comparing test performance, adding dermoscopy to naked eye examination improved sensitivity from 66.9% to 85% (P = .0001) and specificity from 97.2% to 98.2% (P = .006). The sensitivity and specificity of dermoscopy were higher for pigmented than nonpigmented BCC. Sensitivity increased when dermoscopy was performed by experts and when the diagnosis was based on in-person dermoscopy as opposed to dermoscopic photographs.

Limitations

Significant heterogeneity among studies with a medium-to-high risk of bias.

Conclusion

Dermoscopy is a sensitive and specific add-on tool for the diagnosis of BCC. It is especially valuable for pigmented BCC.



中文翻译:

皮肤镜检查对基底细胞癌的诊断准确性:系统评价和荟萃分析

背景

皮肤镜检查是诊断皮肤病变的一种非侵入性技术。其对基底细胞癌(BCC)的准确性尚未得到系统的研究。

客观的

我们试图系统地研究皮肤镜检查与肉眼检查相比对BCC的准确性。

方法

对报告裸眼检查和皮肤镜检查对BCC诊断准确性的研究进行了系统的综述。使用双变量混合效应逻辑回归建模框架进行敏感性和特异性的荟萃分析。

结果

确定了十七项研究。皮肤镜检查对BCC的综合敏感性和特异性分别为91.2%和95%。在比较测试性能的研究中,在裸眼检查中添加皮肤镜检查可以将敏感性从66.9%提高到85%(P  = .0001),将特异性从97.2%提高到98.2%(P  = .006)。有色的BCC皮肤镜检查的敏感性和特异性均高于无色的BCC。当由专家进行皮肤镜检查以及基于皮肤镜检查而不是皮肤镜照片进行诊断时,灵敏度会提高。

局限性

中度偏高风险的研究之间存在显着异质性。

结论

皮肤镜检查是诊断BCC的灵敏且特定的附加工具。它对于着色的BCC特别有价值。

更新日期:2018-12-21
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