面部基底细胞癌临床病理及安全切缘关系的效果评价

Evaluation on the effect of the relationship between the clinical pathology and safety margin of facial basal cell carcinoma

目的:分析面部不同分型基底细胞癌病理特征及安全切缘的关系。方法:2016年5月-2018年5月收治面部基底细胞癌患者99例,对所有患者病理分型进行分析,比较手术切缘对术中首次冷冻切缘阳性率的影响。结果:首次术中冷冻切缘阳性主要与患者面部基底细胞癌分型有较为密切关系;浸润型病症和硬斑病样型病症相较于结节性病症,发生切缘阳性风险更高,差异有统计学意义(P<0.05);而结节性与浅表性面部基底细胞癌切缘阳性率比较,差异无统计学意义(P>0.05)。结论:病理分型是对手术切缘安全造成影响的主要因素,而对于面部结节型和浅表型基底细胞癌选择3 mm手术切缘即可达到理想手术效果;而对于浸润性病症和硬斑病样型病症应根据患者具体状况进行手术切缘,才能保证治疗效果。

Objective:To analyze the relationship between the pathological features and safety margins of different types of facial basal cell carcinoma.Methods:From May 2016 to May 2018,99 patients with facial basal cell carcinoma were enrolled.The pathological types of all patients were analyzed,and the effect of surgical margin on the positive rate of the first frozen margin during operation was compared.Results:The first positive margin of cryosurgery during the operation was mainly related to the type of facial basal cell carcinoma;compared with the tuberous type,the infiltration type and the hard spot type's risk of positive margin were higher,and the differences were statistically significant(P<0.05);the incidence of positive margin between nodular and superficial facial basal cell carcinoma was compared,and the difference was not statistically significant(P>0.05).Conclusion:The pathological type is the main factor affecting the safety of surgical margin,for the nodular type and the superficial type facial basal cell carcinomas,a 3mm surgical margin can be selected to achieve the desired surgical effect;for the infiltration type and the hard spot type facial basal cell carcinomas,the surgical margin should be carried out according to the specific condition of the patients in order to ensure the therapeutic effect.