The role of spectrophotometry in the diagnosis of melanoma

Paolo A Ascierto,Stefano Mori,Giuseppe Palmieri,Ileana De Michele,Antonio Daponte,Maurizio Del Giudice,Antonio Vozza,Nicola Mozzillo,Marco Palla,Ester Simeone,Rocco A Satriano,Fabrizio Ayala,Corrado Caracò

doi:10.1186/1471-5945-10-5

Paolo A Ascierto, Stefano Mori + Show 11 more

Open Access

https://doi.org/10.1186/1471-5945-10-5

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Abstract

BackgroundSpectrophotometry (SPT) could represent a promising technique for the diagnosis of cutaneous melanoma (CM) at earlier stages of the disease. Starting from our experience, we further assessed the role of SPT in CM early detection.MethodsDuring a health campaign for malignant melanoma at National Cancer Institute of Naples, we identified a subset of 54 lesions to be addressed to surgical excision and histological examination. Before surgery, all patients were investigated by clinical and epiluminescence microscopy (ELM) screenings; selected lesions underwent spectrophotometer analysis. For SPT, we used a video spectrophotometer imaging system (Spectroshade® MHT S.p.A., Verona, Italy).ResultsAmong the 54 patients harbouring cutaneous pigmented lesions, we performed comparison between results from the SPT screening and the histological diagnoses as well as evaluation of both sensitivity and specificity in detecting CM using either SPT or conventional approaches. For all pigmented lesions, agreement between histology and SPT classification was 57.4%. The sensitivity and specificity of SPT in detecting melanoma were 66.6% and 76.2%, respectively.ConclusionsAlthough SPT is still considered as a valuable diagnostic tool for CM, its low accuracy, sensitivity, and specificity represent the main hamper for the introduction of such a methodology in clinical practice. Dermoscopy remains the best diagnostic tool for the preoperative diagnosis of pigmented skin lesions.

Highlights

Spectrophotometry (SPT) could represent a promising technique for the diagnosis of cutaneous melanoma (CM) at earlier stages of the disease
ABCDE criteria; when at least two of the ABCDE criteria occurred, individuals were addressed to epiluminescence microscopy (ELM)-based dermoscopy, in order to generate a risk classification
In a period of one year, total-body skin examinations for detection of early malignant melanoma were carried out at National Cancer Institute of Naples; they allowed to identify cutaneous pigmented lesions to be addressed to surgical excision and histological examination in 54 patients [35 females and 19 males; median age, 41]

Summary

Introduction

Spectrophotometry (SPT) could represent a promising technique for the diagnosis of cutaneous melanoma (CM) at earlier stages of the disease. Starting from our experience, we further assessed the role of SPT in CM early detection. The incidence of melanoma in Europe has been steadily increasing, more rapidly than for any other cancer, during recent decades. Incidence of melanoma deeply varies across Europe, with the highest incidence in Scandinavian countries. Lifetime risk of developing melanoma within the entire caucasian population is estimated to be 1:535 individuals. Incidence is higher in individuals with fair skin who have been exposed to high levels of UV-B radiation. Mortality due to metastatic melanoma has increased rapidly in both males and females; such a disease accounts for only 4% of skin cancers, but for 79% of skin-cancer related deaths.

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