诊断鳞状细胞癌的非侵入性技术系统回顾与荟萃分析

Carina Nogueira Garcia , Christoph Wies , Katja Hauser , Titus J. Brinker
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引用次数: 0

摘要

皮肤鳞状细胞癌(cSCC)的早期诊断对于启动适当的靶向治疗至关重要。无创诊断技术可以克服多次活检的需要并减少肿瘤复发。为了评估用于 cSCC 诊断的无创技术的性能,我们通过系统性文献检索找到了 947 条相关记录。在本次系统性综述所选的 15 项研究中,有 7 项纳入了荟萃分析,包括 1144 名患者、224 个 cSCC 病灶和 1729 项临床诊断。总体而言,高频超声的灵敏度为 92%(95% 置信区间 [CI] = 86.6-96.4%),光学相干断层扫描的灵敏度为 75%(95% 置信区间 [CI] = 65.7-86.2%),反射共聚焦显微镜的灵敏度为 63%(95% 置信区间 [CI] = 51.3-69.1%)。总体特异性值分别为 88%(95% CI = 82.7-92.5%)、95%(95% CI = 92.7-97.3%)和 96%(95% CI = 94.8-97.4%)。医生的专业知识是调查设备实现高诊断性能的关键。尽管没有足够的标准化诊断标准,但由于提供了额外的组织信息,需要医生的解释,这一点是合理的。此外,深度学习研究很少。因此,在 cSCC 诊断中,将深度学习整合到调查设备中是一个潜在的研究领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Noninvasive Technologies for the Diagnosis of Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Early cutaneous squamous cell carcinoma (cSCC) diagnosis is essential to initiate adequate targeted treatment. Noninvasive diagnostic technologies could overcome the need of multiple biopsies and reduce tumor recurrence. To assess performance of noninvasive technologies for cSCC diagnostics, 947 relevant records were identified through a systematic literature search. Among the 15 selected studies within this systematic review, 7 were included in the meta-analysis, comprising of 1144 patients, 224 cSCC lesions, and 1729 clinical diagnoses. Overall, the sensitivity values are 92% (95% confidence interval [CI] = 86.6–96.4%) for high-frequency ultrasound, 75% (95% CI = 65.7–86.2%) for optical coherence tomography, and 63% (95% CI = 51.3–69.1%) for reflectance confocal microscopy. The overall specificity values are 88% (95% CI = 82.7–92.5%), 95% (95% CI = 92.7–97.3%), and 96% (95% CI = 94.8–97.4%), respectively. Physician’s expertise is key for high diagnostic performance of investigated devices. This can be justified by the provision of additional tissue information, which requires physician interpretation, despite insufficient standardized diagnostic criteria. Furthermore, few deep learning studies were identified. Thus, integration of deep learning into the investigated devices is a potential investigating field in cSCC diagnosis.

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