颜面部皮肤基底细胞癌的诊断与治疗

Diagnosis and treatment of maxillofacial basal cell carcinoma

目的探讨颜面部皮肤基底细胞癌(basal cell carcinoma,BCC)的诊断与治疗方法。方法回顾性分析22例颜面部BCC患者的临床特征、病理表现及临床治疗方法。结果 BBC患者肿块肉眼通常表现为伴有中央凹陷与蜡样光泽的结节,可出现或不出现溃疡,溃疡处可见结痂或出血,溃疡较大时溃疡边缘会出现卷曲。病理分型:实体型5例(22.7%),角化型4例(18.2%),色素型6例(27.3%),浅表型4例(18.2%),纤维上皮瘤型3例(13.6%);均经手术切除治疗,3例(13.6%)因皮损较小术后直接缝合,19例(86.4%)因皮损较大肿块切除后采取局部皮瓣修复。随访6个月均未出现复发。结论 BCC具有生长缓慢,转移率较低,预后较好的特点。早期诊断与治疗对患者的良好预后影响较大。

Objective To discuss the diagnosis and treatment methods for maxillofacial basal cell carcinoma （BCC）. Methods A retrospective analysis was performed on 22 patients with maxillofacial BCC. The clinical features, pathology and clinical treatments were included. Results These tumors in patients with BCC are typically with central depression and wax-like luster nodules on observation by the naked eye, with or without ulcers, and differentiable scab or bleeding on the ulcers. In larger ulcers, the edge of the ulcer could curl. There were 5 cases of pathological entities （22.7%）, 4 cases of keratosis （ 18.2% ）, 6 pigment cases （27.3%）, 4 superficial cases （ 18.2% ）, and 3 cases of fiber intraepithelial neoplasia （ 13.6% ）. All were treated by surgical resection, with incisions in 3 cases （ 13.6% ） , sutured directly due to the smaller lesions. The others in 19 cases （86.4%） were repaired by local flap after excision due to larger lesions. There were no recurrences after 6 months follow-up. Conclusion BCC has these features： slow growth, low metastasis and good prognosis. Early diagnosis and treatment has an obvious influenceon the patients＇ prognosis.