Background: Line-field confocal optical coherence tomography (LC-OCT) is an innovative non-invasive imaging technique recently introduced in dermatology. Its use has been established particularly in the diagnosis of skin cancer. The LC-OCT description of basal cell carcinoma (BCC) criteria has served for the conduction of retrospective evaluations on its diagnostic performance, which demonstrated its utility in diagnosis and subtyping BCC. However, prospective studies performed at patients’ bedside are currently lacking in this field.Objective: The objective of the study was to provide parameters of LC-OCT diagnostic performance for BCC derived from a prospective study performed at patients’ bedside.Methods: Lesions clinically equivocal for BCC were prospectively included. Dermoscopic and LC-OCT diagnoses were obtained at the patients’ bedside by an expert observer prior to surgical excision or biopsy.Results: A total of 214 lesions (163 BCCs and 51 BCC imitators) belonging to 119 patients were included. For the differentiation of BCC from BCC-imitators, LC-OCT had the same sensitivity as dermoscopy (98%) but a better specificity (90% vs. 37%). For the discrimination of superficial BCC from other BCC subtypes, LC-OCT had an increased sensitivity and specificity compared to dermoscopy (72% vs. 62%, and 97% vs. 84%, respectively).Conclusions: This prospective study showed that the diagnostic performance for BCC diagnosis and subtyping can be remarkedly increased by LC-OCT compared to dermoscopic examination alone. Our data encourages the inclusion of LC-OCT in the diagnostic process and management of equivocal lesions for BCC.
背景：线场共聚焦光学相干断层扫描（LC-OCT）是近年来引入皮肤科领域的一种创新性无创成像技术，其应用尤其在皮肤癌诊断中得到确立。基于已建立的基底细胞癌（BCC）LC-OCT诊断标准，既往回顾性研究已证实该技术在BCC诊断及亚型鉴别中的价值，但目前尚缺乏在患者床旁开展的前瞻性研究。 目的：本研究旨在通过床旁前瞻性研究，提供LC-OCT诊断BCC的效能参数。 方法：前瞻性纳入临床疑似BCC的皮损，由专家观察者在手术切除或活检前，于患者床旁分别进行皮肤镜及LC-OCT诊断评估。 结果：共纳入119例患者的214个皮损（163个BCC与51个BCC模拟病变）。在区分BCC与BCC模拟病变方面，LC-OCT与皮肤镜的灵敏度相同（98%），但特异度更高（90% vs. 37%）。在鉴别浅表型BCC与其他BCC亚型方面，LC-OCT的灵敏度与特异度均优于皮肤镜（分别为72% vs. 62%，97% vs. 84%）。 结论：本前瞻性研究表明，与单纯皮肤镜检查相比，LC-OCT可显著提升BCC诊断及亚型鉴别的效能。我们的数据支持将LC-OCT整合到BCC可疑皮损的诊断流程与管理决策中。
肿瘤(癌症)患者之家