超高频超声在区分浅表性基底细胞癌和 Bowen 病方面的价值。
The value of ultra-high frequency ultrasound for the differentiation between superficial basal cell carcinoma and Bowen's disease.
发表日期：2023 Feb 02
作者：
Ya-Qin Zhang, Li-Fan Wang, Na Ni, Xiao-Long Li, An-Qi Zhu, Le-Hang Guo, Qiao Wang, Hu-Xiong Xu
来源：
DERMATOLOGY
摘要：
表浅性基底细胞癌（sBCC）和Bowen病（BD）在视觉上的相似外观可能会导致诊断上的困惑。为了探究超高频超声（uHFUS）在区分sBCC和BD方面的价值，我们进行了这项前瞻性研究。研究包括2016年11月至2020年10月的110名患者（73例BD和37例sBCC）的初步队列和2021年7月至2021年12月的42名患者（30例BD和12例sBCC）的验证队列。评估了病理学证实的sBCC和BD的临床和uHFUS特征，基于初步队列的HFUS特征开发了预测模型。随后，该模型在验证队列中进行了验证，并与临床诊断进行了比较。在sBCC和BD之间具有显着差异的uHFUS特征包括病变表面、皮肤层次的涉及、表皮增生和高回声斑点（所有p < 0.05）。基于以上特征建立了一种预测模型，在初步队列和验证队列中识别出sBCC和BD，其曲线下面积（AUC）分别为0.908和0.923，敏感度分别为82.3%和83.3%，特异度分别为91.9%和91.7%，准确度分别为85.5%和85.7%，均显著高于基于病变照片的临床诊断，其曲线下面积（AUC）为0.692，敏感度为63.3%，特异度为75.3%，准确度为66.7%（所有p < 0.05）。uHFUS提供了sBCC和BD的细致内部特征，有助于区分sBCC和BD，并且其诊断表现优于临床诊断。S. Karger AG, Basel.
The similar visual appearance of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) may cause confusion for diagnosis.To investigate the value of ultra-high frequency ultrasound (uHFUS) in differentiating sBCC from BD.This prospective study included a pilot cohort of 110 patients (73 BDs and 37 sBCCs) from November 2016 to October 2020 and a validation cohort of 42 patients (30 BDs and 12 sBCCs) from July 2021 to December 2021. Clinical and uHFUS features of pathologically confirmed sBCC and BD were assessed. A predictive model was developed based on the HFUS features of the pilot cohort. Subsequently, the model was validated and compared with clinical diagnosis in the validation cohort.uHFUS features with significant differences between sBCC and BD included lesion surface, skin layer involvement, hyperkeratosis, and hyperechoic spots (all p < 0.05). A prediction model based on the above features was established to identify sBCC and BD in the pilot and validation cohorts with the areas under the curve (AUC) of 0.908 and 0.923, sensitivity of 82.3% and 83.3%, specificity of 91.9% and 91.7%, accuracy of 85.5% and 85.7%, respectively, which was significantly higher than those obtained by clinical diagnosis based on photographic pictures of lesions, with the AUC of 0.692, sensitivity of 63.3%, specificity of 75.3%, and accuracy of 66.7% (all p < 0.05).uHFUS provides detailed internal features of sBCC and BD, which facilitates the differentiation between sBCC and BD and its diagnostic performance is superior to clinical diagnosis.S. Karger AG, Basel.