489 KB26 KB199220251999Argenziano, GiusseppeCarli, PaoloDe Giorgi, VincenzoDelfino, MarioFabbrocini, GabrielaSammarco, Elenaletnik:33str. S27-34številka:suppl. 1COBISSID_HOST:10733273ISSN:1318-2099URN:URN:NBN:SI:doc-PFO51XC2slCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)DiagnosisLuminescenceMelanomaNevus, pigmentedPathologySkin neoplasmsEpiluminiscenčna mikroskopija v diagnostiki nejasnih melanocitnih kožnih spreemb: primerjava dermatoskopskih ABCD pravil z novo sedem točkovno listo preverjanja, ki temelji na analizi vzorcev| Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions: a comparison of the ABCD rule of dermatoscopy and new seven-point checklist based on pattern analysis|Objective: To compare the reliability of a new seven-point checklist based on a simplified epiluminescence microscopy (ELM) pattern analysis with the ABCD rule of dermatoscopy and standard patern analysis for the diagnosis of clinically doubtful melanocitic skin lesions. Design: In a blind study ELM images of 342 histologically proven melanocytic skin lesion were evaluated forthe presence of 7 standard criteria that we called "ELM seven-point checklist". For each lesion "overal"l and "ABCD scored" diagnoses were recorded. From a training set of 57 melanomas and 139 atypical nonmelanomas, odds ratios were calculated to create a simple diagnostic model based on identification of major and minor criteria for the "seven-point scored" diagnosis. A test set of 60 melanomas and 86 atypical nonmelenomas wasused formodel validation and was presented to two less experienced ELM observers, who recorded the ABCD and seven-point scored diagnoses. Setting: University Medical Centers. Patients: A sample of subjects with excised melanocytic lesions. Main outcome measures: Sensitivity, specificity, and accuracy of the models for diagnosing melanoma. Results: From the total combined sets the seven-point checklist gave a sensitivity of 95% and specificity of 75%, compared with 85% sensitivity and 66% specificity using ABCD rule, and 91% sensitivity and 90% specificity using standard pattern analysis (overall ELM diagnosis). Compared with ABCD rule, the seven-point meethod allowed less experienced observers to obtain higher diagnostic accuracy values. Conclusions: The ELM seven-point checklist provides a simplification of the standard pattern analysis becauseof the low number of features to identify andthe scoring diagnostic system. (Abstract truncated at 2000 characters.)Cilji. Primerjava zanesljivosti nove sedem točkovne liste preverjanja, ki temelji na poenostavljeni epiluminiscenčno mikroskopski (ELM) vzorčni analizi,z ABCD pravili dermatoskopije in standardno analizo vzorcev, v diagnostiki klinično nejasnih melanocitnih kožnih sprememb. Način: V slepi študiji je bilo, po sedmih standardnih kriterijih, ki smo jih poimenovali "ELMsedemtočkovna lista preverjanja", ocenjenih 342 ELM slik histološko dokazanih melanocitnih kožnih sprememb. Vsaka posamezna kožna sprememba je bila diagnostično opredeljena po celokupnem kot tudi ABCD principu točkovanja.Iz "training set-a" 57-ih melanomov in 139-ih atipičnih ne-melanomov smo izračunali razmerje obetov (odds ratios) za postavitev preprostega diagnostičnega modela, ki temelji na prepoznavanju major in minor kriterijev po sedem točkovni listi preverjanja. Za ovrednotenje modela smo uporabili testni set 60 melanomov in 86 atipičnih ne-melanomov. Ti so bili predstavljeni dvema izkušenima ELM opazovalcema, ki sta jih diagnosticirala poprincipu zadetkov ABCD in sedem točkovne liste preverjanja. Kraj: Unerzitetni medicinski centri. Pacienti: Vzorec oseb z ekscidiranimi melanocitnimi spremembami. Poglavitni izzidi meritev: Senzitivnost, specifičnost in natančnost modelov za diagnostiko melanoma. Rezultati: Iz vsehkombiniranih setov je metoda sedem točkovne liste preverjanja pokazala 95%senzitivnost in 75% specifičnost v primerjavi z 85% senzitivnostjo in 66% specifičnostjo metode ABCD pravil in 91% senzitivnostjo standardne metode analize vzorca (overall ELM diagnosis). V primerjavi z ABCD pravili, sedem točkovna lista preverjanja omogoča manj izkušeniih klinikom doseči višjo stopnjo diagnostične pravilnosti. Zaključek: ELM sedem točkovna lista preverjanja omogoča poenostavitev standardne analize vzorcev zaradi majhnega števila kriterijev, ki jih je potrebno identificirati ter primernega sistema zadetkov za postavljanje diagnoze. (Izvleček prekinjen pri 2000 znakih.)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana