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A Systematic Review and Meta-Analysis of the Accuracy of in Vivo Reflectance Confocal Microscopy for the Diagnosis of Primary Basal Cell Carcinoma

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Department of Dermatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Department of Plastic and Reconstructive Surgery, “Bagdasar-Arseni” Clinical Emergency Hospital, 041915 Bucharest, Romania
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Department of Dermatology, “Elias” University Emergency Hospital, 011461 Bucharest, Romania
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Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
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“Titu Maiorescu” University, Faculty of Medicine, 031593 Bucharest, Romania
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Department of Dermatology, “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(9), 1462; https://doi.org/10.3390/jcm8091462
Received: 3 September 2019 / Revised: 12 September 2019 / Accepted: 12 September 2019 / Published: 13 September 2019
(This article belongs to the Special Issue Current Advances on Non-Melanoma Skin Cancer)
Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies’ methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87–0.95; I2 = 85.27%) and 0.93 (95% CI, 0.85–0.97; I2 = 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8–31.37; I2 = 91.01%) and 0.08 (95% CI, 0.05–0.14; I2 = 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73–397.02; I2 = 71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC. View Full-Text
Keywords: basal cell carcinoma; diagnostic test accuracy; in vivo; reflectance confocal microscopy; systematic review; meta-analysis basal cell carcinoma; diagnostic test accuracy; in vivo; reflectance confocal microscopy; systematic review; meta-analysis
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MDPI and ACS Style

Lupu, M.; Popa, I.M.; Voiculescu, V.M.; Caruntu, A.; Caruntu, C. A Systematic Review and Meta-Analysis of the Accuracy of in Vivo Reflectance Confocal Microscopy for the Diagnosis of Primary Basal Cell Carcinoma. J. Clin. Med. 2019, 8, 1462.

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