External validation and comparison of four confocal microscopic scores for melanoma diagnosis on a retrospective series of highly suspicious melanocytic lesions

摘要: BACKGROUND In vivo reflectance confocal microscopy significantly improves melanoma diagnosis as compared to clinical/dermoscopic examination alone. Several criteria have been described allowing differentiate from nevi; by combining different criteria, three pure scores (Pellacani 2005, Segura 2009 and Pellacani 2012) one mixed dermoscopic/confocal score (Borsari 2018) were constructed. OBJECTIVE Our aim was externally validate compare the performance of these scores. METHODS We retrospectively enrolled excised melanocytic lesions which underwent in a 2-year period. Lesions located on face acral sites excluded. Both dermoscopic considered four evaluated experts. Subsequently, specificity sensitivity levels for each calculated, together with positive negative predictive values likelihood ratios; also, receiver operating characteristic curves RESULTS A total 389 patients 422 enrolled, 162 (38.4%) melanomas 260 (61.6%) nevi (189 common 71 Spitz/Reed nevi). The highest recorded cut-off ≥-1 (92.0%), while 2005 ≥5 achieved (69.6%). Borsari et al. showed (59.8% 91.5%) ratios (2.4 0.1) well area under curve (0.76; 95% CI 0.72-0.81; P < 0.001). CONCLUSIONS High accuracy found No differences among confirming when positive; however, 2018 best excluding negative.