Diagnostic accuracy of dermatofluoroscopy in cutaneous melanoma detection: results of a prospective multicentre clinical study in 476 pigmented lesions
| Autor: | Holger A. Haenssle, Iris Spänkuch, Andrea Forschner, Benjamin Weide, Ioanna Tampouri, Maja A. Hofmann, Thomas Eigentler, Christine Fink, Ulrike Keim, Claus Garbe, Diana Lomberg |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Skin Neoplasms Biopsy Dermoscopy Dermatology Sensitivity and Specificity 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests medicine Clinical endpoint Humans Prospective Studies Prospective cohort study Melanoma Early Detection of Cancer Aged Skin medicine.diagnostic_test business.industry Middle Aged medicine.disease Clinical trial 030220 oncology & carcinogenesis Predictive value of tests Fluoroscopy Cutaneous melanoma Feasibility Studies Histopathology Female business |
| Zdroj: | The British journal of dermatology. 179(2) |
| ISSN: | 1365-2133 |
| Popis: | Background Early detection is a key factor in improving survival from melanoma. Today, the clinical diagnosis of cutaneous melanoma is based mostly on visual inspection and dermoscopy. Preclinical studies in freshly excised or paraffin-embedded tissue have shown that the melanin fluorescence spectra after stepwise two-photon excitation, a process termed dermatofluoroscopy, differ between cutaneous melanoma and melanocytic naevi. However, confirmation from a larger prospective clinical study is lacking. Objectives The primary end point of this study was to determine the diagnostic accuracy of dermatofluoroscopy in melanoma detection. Secondary end points included the collection of data for improving the computer algorithm that classifies skin lesions based on melanin fluorescence and the assessment of safety aspects. Methods This was a prospective, blinded, multicentre clinical study in patients with pigmented skin lesions (PSLs) indicated for excision either to rule out or to confirm cutaneous melanoma. All included lesions underwent dermoscopy and dermatofluoroscopy in vivo before lesions were excised and subjected to histopathological examination. Results In total, 369 patients and 476 PSLs were included in the final analysis. In 101 of 476 lesions (21·2%) histopathology revealed melanoma. The observed sensitivity of dermatofluoroscopy was 89·1% (90 of 101 melanomas identified), with an observed specificity of 44·8%. The positive and negative predictive values were 30·3% and 93·9%, respectively. No adverse events occurred. Conclusions Dermatofluoroscopy is a safe and accurate diagnostic method to aid physicians in diagnosing cutaneous melanoma. Limitations arise from largely amelanotic or regressing lesions lacking sufficient melanin fluorescence. |
| Databáze: | OpenAIRE |
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