皮肤基底细胞癌32例临床病理分析

Clinical pathological analysis of 32 cases of basal cell carcinoma of skin

目的：总结探讨BCC（皮肤基底细胞癌）临床病理特征，以期提高皮肤基底细胞癌的诊断水平。方法选择2010年1月～2016年1月期间我院收治的32例皮肤基底细胞癌患者为研究对象，回顾分析其临床病理资料，总结其病理特征。结果32例皮肤基底细胞癌患者中，根据其病理组织特征划分为实体型23例、腺样型2例、角化型2例、色素型2例、浅表型2例。表皮角化不全6例、角化过度4例，棘层增厚3例、表皮萎缩17例，基底液化变性9例、炎性细胞浸润10例，部分患者肿瘤组织上方表皮萎缩、两侧棘层增厚。其中16例肿瘤组织连接表皮，11例与毛囊相连。32例患者真皮都有一定程度淋巴组织浸润，8例浆细胞浸润，9例中性粒细胞浸润，11例真皮乳头和浅层血管增生。22例瘤细胞及周围间质中有色素颗粒。典型肿瘤细胞与基底细胞相似，瘤细胞栅栏状排列。在32例标本中3例细胞核分裂象增多，29例标本中肿瘤细胞与间质间有裂隙。结论皮肤基底细胞癌与某些皮肤肿瘤具有相似的临床表现，临床误诊率较高，病理学检查是早期诊断、治疗的有效辅助手段。

Objective To summarize the clinical and pathological features of BCC (cutaneous basal cell carcinoma) in order to improve the diagnostic level of skin basal cell carcinoma. Methods 32 cases of cutaneous basal cell carcinoma in our hospital from January 2010 to January were selected as the study subjects. The clinical pathological data were retrospectively analyzed to summarize the pathological characteristics of the patients. Results in 32 cases of basal cell carcinoma of skin, according to the pathological characteristics, it was divided into 23 cases, 2 cases of adenoid type, cases of type 2, 2 cases of pigment type and 2 cases of superficial phenotype. In 6 cases, cases of epidermal keratin, 4 cases of excessive keratin, 3 cases of thickening of the spine, 17 cases of skin atrophy, 9 cases of basal liquefaction degeneration, 10 cases of inflammatory cell infiltration. Of which 16 cases of tumor tissue connecting epidermis, 11 cases associated with hair follicles. 32 patients have a certain degree of dermal infiltration of lymphoid tissue, 8 cases of plasma cell infiltration, 9 cases of neutrophil infiltration, 11 cases of papillary dermis and superficial vascular hyperplasia. 22 cases of tumor cells and the surrounding stroma in pigment granules. Typical tumor cells and basal cells similar to tumor cells palisading. In 32 specimens 3 cases mitoses increased in 29 specimens of tumor cells and stroma between the cracks. Conclusion skin basal cell carcinoma and some skin tumors with similar clinical manifestations, clinical misdiagnosis rate, pathological examination is effective early diagnosis and treatment of aids.