Abstract
Background: Nonmelanoma skin cancer (Basal Cell Cancer (BCC) and Squamous Cell Cancer (SCC)) are the most prevalent cancer in the light-skinned population. The incidence of melanoma has been increasing steadily throughout the world. Early recognition of skin cancer without doing biopsy remains challenging. The development of noninvasive diagnostic technologies is highly relevant and desired. Confocal Laser Scanning Microscopy (CLSM) enables in vivo and ex vivo imaging of human skin at a quasi-histologic resolution. Methods and Materials: Several databases like Medline, Embase, all EBM reviews (ACP Journal Club, Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects) and Journals@Ovid were used to perform a literature search on CLSM in the diagnosis of melanoma and non melanoma skin cancers. Standards for Reporting of Diagnosis Accuracy (STARD) initiative checklist and National Institute for Health and Clinical Excellence (NICE) guidelines on methodology were used to assess the quality of the studies found. Eight studies fulfilling relevant criteria inclusive of assessment of diagnostic accuracy of CSLM and histopathology were selected. Heterogeneity among the studies was assessed and the data was pooled for meta- analysis. Results: The eight included studies did not have considerable heterogeneity between them. The pooled sensitivity for melanoma diagnosis was 91.4% and for BCC diagnosis was 90.1%. Pooled specificities were 79.9% and 92.6% for malignant melanoma and BCC respectively. Diagnostic odds ratios for melanoma and BCC were 80.1 and 358.1 respectively. Conclusions: From the limited good quality available literature we found that CLSM has the potential to be an additional noninvasive diagnostic test to dermoscopy for the diagnosis of BCC and melanoma.
Highlights
The incidence of non melanoma skin cancer, Basal Cell Carcinoma (BCC) and SCC has increased by 10% per annum; with 2-3 million new cases diagnosed worldwide each year [1]
Standards for Reporting of Diagnosis Accuracy (STARD) initiative checklist and National Institute for Health and Clinical Excellence (NICE) guidelines on methodology were used to assess the quality of the studies found
From the limited good quality available literature we found that Confocal Laser Scanning Microscopy (CLSM) has the potential to be an additional noninvasive diagnostic test to dermoscopy for the diagnosis of BCC and melanoma
Summary
The incidence of non melanoma skin cancer, BCC and SCC has increased by 10% per annum; with 2-3 million new cases diagnosed worldwide each year [1]. Worldwide the incidence of melanoma is increasing faster than any other cancer, with rates doubling every 10-20 years in the Caucasian population. Dermoscopy has been in routine use for the diagnosis of the skin cancer It provides a non invasive, rapid, in vivo examination of the superficial layers of the skin. It has a sensitivity and specificity of 86% and 89% respectively for cutaneous melanoma [5]. CLSM, a non-invasive diagnostic tool, was first reported in 1995 to be used in vivo on human tissue [8]. Confocal Laser Scanning Microscopy (CLSM) enables in vivo and ex vivo imaging of human skin at a quasi-histologic resolution
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