251例基底细胞癌患者的临床及病理特征回顾性分析

Retrospective Analysis for Clinical and Histopathological Features of Basal Cell Carcinoma in 251 Patients

目的:通过分析新疆医科大学第一附属医院患者基底细胞癌的临床及病理资料,了解中国西北地区基底细胞癌的临床病理特点及发病情况。方法:回顾2006年1月-2016年10月笔者科室病理诊断为基底细胞癌的患者病历资料,并进行数据分析。结果:共收集251例基底细胞癌患者,男女比为1.06:1,平均发病年龄(55.86±13.64)岁,平均就诊年龄(60.08±13.35)岁,头面部发病最多(占88.45%),依据临床及病理分型,结节/溃疡型占66.14%、色素型26.69%、浅表型6.37%、硬斑病样0.80%;病程超过2年者78.09%,平均病程50.8个月。40岁以上发病者86.85%,但40岁以下的基底细胞癌患者占13.15%。在临床与病理诊断符合率方面,基底细胞癌的符合率为79.28%,其中色素型基底细胞癌误诊为色素痣的比例为25.37%。结论:在新疆地区的基底细胞癌患者中,头面曝光部位仍是好发部位,最常见的基底细胞癌临床类型为结节溃疡型,其次是色素型。多发基底细胞癌患者较少,皮脂腺痣并发基底细胞癌的病例年龄较小。中青年基底细胞癌患者占有一定的比例,应进一步提高皮肤科医生临床诊断基底细胞癌的能力。

Objective To investigate the clinical and histopathologic data, understand the features and incidence of basal cell carcinoma（BCC） in The First Affliated Hospital of Xinjiang Medical University in West-northern China. Methods Clinical data of basal cell carcinoma confirmed histopathologically from 2006 to 2016 in The First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed by using statistical methods. Results Among 251 patients enrolled, the ratio of male to female was 1.06：1, the average age of onset was（55.86±13.64） years, average age of visit was（60.08±13.35） years. The head and face were the most common sites of BCC（88.45%）. According to clinical and histopathologic type, nodular/ulcer subtype accounted for 66.14%, pigmentary subtype 26.69%, superficial subtype 6.37%, morpheaform subtype 0.80%. The course of disease over 2 years accounted for 78.09%, the average course was 50.8 months. Over 40 years old patients with onset was 86.85%, but under 40 years old accounted for 13.15%, the incidence of the head and neck was still dominated（88.45%）. In accordance with the clinical diagnosis and pathologic diagnosis, the coincidence rate of BCC was 79.28%, and the proportion of pigmentary BCC misdiagnosed as nevi was 25.37%. Conclusion The patients of BCC in Xinjiang area,the head and face is still the predilection site,the most common BCC subtype was nodular/ulcer subtype, followed by pigmentary subtype. Patients with multiple BCC were seldom, and the BCC cases with sebaceous nevus were younger. Young-middle aged patients with BCC had a certain proportion. At the same time, we should improve the ability of clinical diagnosis in BCC.