Artículo de revista
Asertividad en el diagnóstico clínico de los tumores cutáneos
Fecha
2003Registro en:
Rev Méd Chile 2003; 131: 1421-1427
00349887
Autor
Zemelman Decarli, Viviana
Valenzuela, Carlos Y.
Fisch, Félix
Road, Johanna
Honeyman Mauro, Juan
Institución
Resumen
Background: There is an increase in the incidence rates of skin
cancer in Chile. Aim: To study the clinical diagnostic accuracy (CDA) for skin cancer. Material
y methods: CDA was defined as the percentage of agreement between clinical and pathological
diagnosis. Approximately 600,000 pathological reports from five hospitals in Santiago were reviewed.
A total of 2,593 skin tumours; 230 Malignant Melanoma (MM); 412 Squamous Cell Carcinoma
(SCC) and 1,951 Basal Cell Carcinoma (BCC) were studied. These tumours were clinically
diagnosed and surgically treated by dermatologists. The CDA was studied for each tumour,
by the anatomical localization of the tumour, Breslow Index in MM, by age and sex of the patient.
Results: The highest CDA was observed for BCC (76.2%); followed by MM (64.3%) and
SCC (34.7%). By anatomical localization, for MM the highest CDA was observed in the soles (p
<0.05); for BCC, the hightest CDA was in the face (p <0.05). No significant differences were observed
in SCC. By age, for MM, the CDA was higher in patients aged less than 50 years. No differences
in CDA by age were observed in the other two tumours. By sex, no differences were found.
A higher CDA was found in MM with Breslow indexes III and IV than for MM with Breslow indexes
I and II. Conclusions: CDA is affected by the clinical variables analyzed in this study. A
more accurate clinical diagnosis of skin cancer could be obtained taking into account these
variables.