皮肤镜检查在黑素细胞痣、脂溢性角化病和基底细胞癌中的诊断价值  

Diagnostic value of dermoscopy in melanocytic nevus,seborrheic keratosis and basal cell carcinoma

作　　者：崔莉[1] 王贵佐[1] 马小萍[1] 尚亚洲 刘智 CUI Li;WANG Guizuo;MA Xiaoping;SHANG Yazhou;LIU Zhi(Department of Dermatology,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院,陕西西安710068 [2]陕西省交通医院,陕西西安710068

出　　处：《陕西医学杂志》2021年第4期428-431,442,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2020JM-656)。

摘　　要：目的:探讨皮肤镜在黑素细胞痣、脂溢性角化病、基底细胞癌中的诊断价值。方法:选择临床诊断为黑素细胞痣、脂溢性角化病和基底细胞癌的病例,以组织病理诊断为金标准,研究皮肤镜诊断三种疾病的灵敏度和特异度及与组织病理诊断的一致性结果。结果:①两名医师使用皮肤镜诊断黑素细胞痣的符合率、灵敏度、特异度、误诊率、漏诊率、Youden指数分别是95.1%、95.4%、93.8%、6.3%、4.6%、89.2%和94%、94.1%、93.8%、6.3%、5.9%、87.9%。②两名医师使用皮肤镜诊断脂溢性角化病的符合率、灵敏度、特异度、误诊率、漏诊率、Youden指数分别是93.2%、94%、91.2%、8.8%、6%、85.2%和93.2%、95.2%、88.2%、11.8%、4.8%,83.4%。③两名医师使用皮肤镜诊断基底细胞癌的符合率、灵敏度、特异度、误诊率、漏诊率、Youden指数分别是90.8%、90.9%、90.5%、9.5%、9.1%、81.4%和90.8%、93.1%、85.7%、14.3%、6.8%、78.8%。两名医师经皮肤镜诊断黑素细胞痣、脂溢性角化病、基底细胞癌的水平经卡方检验均无统计学差异(χ^(2)=0.066、0.082、0.137,均P>0.05)。结论:皮肤镜对黑素细胞痣、脂溢性角化病、基底细胞癌具有较好的诊断准确率,值得临床推广应用。Objective:To determine the diagnostic value of dermoscopy in melanocytic nevus,seborrheic keratosis and basal cell carcinoma.Methods:The patients with melanocytic nevus,seborrheic keratosis and basal cell carcinoma were selected.With histopathological diagnosis as the gold standard,the sensitivity and specificity of dermoscopy in the diagnosis of three diseases and its consistency with histopathological diagnosis were studied.Results:The coincidence rate,sensitivity,specificity,misdiagnosis rate,missed diagnosis rate and Youden index of two doctors using dermoscopy in the diagnosis of melanocytic nevus were 95.1%,95.4%,93.8%,6.3%,4.6%,89.2%and 94%,94.1%,93.8%,6.3%,5.9%and 87.9%,respectively.The coincidence rate,sensitivity,specificity,misdiagnosis rate,missed diagnosis rate and Youden index of two doctors using dermoscopy in the diagnosis of seborrheic keratosis were 93.2%,94%,91.2%,8.8%,6%,85.2%and 93.2%,95.2%,88.2%,11.8%,4.8%,83.4%,respectively.The coincidence rate,sensitivity,specificity,misdiagnosis rate,missed diagnosis rate and Youden index of two doctors using dermoscopy in the diagnosis of basal cell carcinoma were 90.8%,90.9%,90.5%,9.5%,9.1%,81.4%and 90.8%,93.1%,85.7%,14.3%,6.8%,78.8%,respectively.There was no significant difference in the diagnostic levels of melanocytic nevus,seborrheic keratosis and basal cell carcinoma between the two doctors(all P>0.05).Conclusion:Dermoscopy has good diagnostic accuracy in melanocytic nevus,seborrheic keratosis and basal cell carcinoma,which is worthy of clinical application.

关 键 词：黑素细胞痣 脂溢性角化病 基底细胞癌 皮肤镜 组织病理 诊断 

分 类 号：R751[医药卫生—皮肤病学与性病学]