203例皮肤基底细胞癌临床与病理分析

Clinical and Pathological Analysis of Basal Cell Carcinoma in 203 Patients

目的研究分析基底细胞癌(Basal cell carcinoma,BCC)临床表现及组织病理特征,提高基底细胞癌的诊治水平。方法对203例基底细胞癌患者的临床表现、组织病理进行综合分析。结果所收集203例病例中,男女比例为1∶1.23,年龄<50岁的病例占9.36%,其中<60岁的病例中男女比例为1.37∶1。头面部BCC发生率最高占90.15%,病理分型中结节囊肿型66.7%,浅表型14.29%。在临床与病理符合率的比较中,头面部最高(86.34%)四肢最低(45.45%),色素型符合率66.7%。复发病例中以鼻部及眶周最多占56.25%,且病理分型中硬斑病样型占31.25%。结论基底细胞癌中,中青年患者占有一定比例,性别比例与老年患者不同;头面部为基底细胞癌的高发部位,病理分型中以色素型及浅表型误诊率高;临床中复发病例多发生在鼻部及眶周,硬斑病样型占较高比例;及时行病理活检对BCC的早期治疗、治疗方案的选择及预后至关重要。

Objective In order to study the clinical and pathologic features of basal cell carcinoma BCC , and to improvethe level of diagnosis and treatment of BCC. Methods Clinical and pathological data of 203 patients with basal cellcarcinoma were analyzed. Results Among 203 patients enrolled, the male/female ratio was 1 1.23, the patients younger than50 years accounted for 9.63%, among the patients older than 60 years, and the male/female ratio was 1.37 1. The incidence ofbasal cell carcinoma in the head and face was the highest, accounting for 90.15%. In the pathological type, nodular cystic andsuperficial accounted for 66.7% and 14.29% respectively. In the comparison of clinical and pathological coincidence rate, thehead and face were the highest 86.34% and the four limbs were the lowest 45.45% , the pigment type coincidence rate was66.7%. The head and face BCC accounted for 81.25% of cases of recurrences, the nose and orbit accounted for 56.25%, andthe morpheaform type accounted for 31.25%. Conclusion In the basal cell carcinoma, the young and middle-aged patientshad a certain proportion, and the sex ratio was different from the elderly patients. The head and face were the most commonsites of basal cell carcinoma, the misdiagnosis rate of pigment type and superficial type were high in the pathological type. Thecases of recurrence were almost occurred in nose and orbit, and the morpheaform type accounted for a higher proportion.Timely pathological diagnosis is vitally important to early treatment of BCC, treatment options and prognosis.