The clinical value of reflectance confocal microscopy in monitoring treatment of actinic keratosis: A systematic review

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-03-01 DOI:10.1016/j.pdpdt.2025.104539

Jinrui Zhang, Haolong Ran, Yongyao Zhao, Xiyu Liang, Zhiqian Gu, Yanning Xue

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引用次数: 0

Abstract

Background

Actinic keratosis (AK) is a precancerous skin lesion that can progress to squamous cell carcinoma (SCC). Early diagnosis and effective treatment are crucial, but current treatment evaluation methods lack consistency. Reflectance confocal microscopy (RCM) has emerged as a promising non-invasive tool for monitoring treatment outcomes in AK, but the absence of standardized evaluation protocols limits its clinical applicability.

Objective

This study aims to establish standardized RCM imaging features for evaluating treatment responses in AK, thereby enhancing the consistency and clinical utility of RCM in treatment monitoring.

Methods

A systematic review was conducted following the PRISMA 2020 guidelines. Studies that evaluated the treatment of AK using RCM were included. A comprehensive literature search was performed across MEDLINE, Embase, and the Cochrane Library up to October 2024. Data on study design, treatment modalities, RCM imaging features, and scoring systems were extracted. A meta-analysis was not performed due to heterogeneity in study designs and outcome measures.

Conclusion

This review identifies key RCM imaging features of AK, including keratinocyte atypia and architectural disarray, and highlights the lack of a standardized scoring system for evaluating treatment outcomes. The findings underscore the need for a universally accepted protocol to improve the consistency and reliability of RCM in clinical practice. Standardization of RCM evaluation will enhance its utility in both clinical monitoring and future research on AK treatment.

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背景：日光性角化病（AK）是一种癌前皮肤病变，可发展为鳞状细胞癌（SCC）。早期诊断和有效治疗至关重要，但目前的治疗评估方法缺乏一致性。反射共聚焦显微镜（RCM）已成为监测 AK 治疗效果的一种很有前途的非侵入性工具，但标准化评估方案的缺乏限制了其临床应用性：本研究旨在建立用于评估 AK 治疗反应的标准化 RCM 成像特征，从而提高 RCM 在治疗监测中的一致性和临床实用性：方法：按照 PRISMA 2020 指南进行了系统性回顾。方法：按照 PRISMA 2020 指南进行了一项系统性综述，纳入了使用 RCM 评估 AK 治疗的研究。在 MEDLINE、Embase 和 Cochrane 图书馆中进行了全面的文献检索，直至 2024 年 10 月。提取了有关研究设计、治疗方式、RCM 影像特征和评分系统的数据。由于研究设计和结果测量存在异质性，因此未进行荟萃分析：本综述确定了 AK 的主要 RCM 影像特征，包括角质细胞不典型性和结构紊乱，并强调了缺乏评估治疗结果的标准化评分系统。研究结果强调，有必要制定一个普遍接受的方案，以提高 RCM 在临床实践中的一致性和可靠性。RCM 评估的标准化将提高其在临床监测和未来 AK 治疗研究中的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.