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Sensitivity and specificity of confocal laser-scanning microscopy for in vivo diagnosis of malignant skin tumors
Article first published online: 13 APR 2006
Copyright © 2006 American Cancer Society
Volume 107, Issue 1, pages 193–200, 1 July 2006
How to Cite
Gerger, A., Koller, S., Weger, W., Richtig, E., Kerl, H., Samonigg, H., Krippl, P. and Smolle, J. (2006), Sensitivity and specificity of confocal laser-scanning microscopy for in vivo diagnosis of malignant skin tumors. Cancer, 107: 193–200. doi: 10.1002/cncr.21910
- Issue published online: 16 JUN 2006
- Article first published online: 13 APR 2006
- Manuscript Accepted: 20 JAN 2006
- Manuscript Revised: 19 JAN 2006
- Manuscript Received: 14 NOV 2005
- Fond zur Forderung der wissenschaftlichen Forschung. Grant Number: Project 16206-B05
- confocal laser-scanning microscopy;
- malignant melanoma;
- basal cell carcinoma
Melanoma and nonmelanoma skin cancer are the most frequent malignant tumors by far among whites. Currently, early diagnosis is the most efficient method for preventing a fatal outcome. In vivo confocal laser-scanning microscopy (CLSM) is a recently developed potential diagnostic tool.
One hundred seventeen melanocytic skin lesions and 45 nonmelanocytic skin lesions (90 benign nevi, 27 malignant melanomas, 15 basal cell carcinomas, and 30 seborrheic keratoses) were sampled consecutively and were examined using proprietary CLSM equipment. Stored images were rated by 4 independent observers.
Differentiation between melanoma and all other lesions based solely on CLSM examination was achieved with a positive predictive value of 94.22%. Malignant lesions (melanoma and basal cell carcinoma) as a group were diagnosed with a positive predictive value of 96.34%. Assessment of distinct CLSM features showed a strong interobserver correlation (κ >0.80 for 11 of 13 criteria). Classification and regression tree analysis yielded a 3-step algorithm based on only 3 criteria, facilitating a correct classification in 96.30% of melanomas, 98.89% of benign nevi, and 100% of basal cell carcinomas and seborrheic keratoses.
In vivo CLSM examination appeared to be a promising method for the noninvasive assessment of melanoma and nonmelanoma skin tumors. Cancer 2006. © 2006 American Cancer Society.