Scrivener Y, Grosshans E, Cribier B
Laboratoire d'Histopathologie Cutanée, Clinique Dermatologique des Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, F-67091 Strasbourg cedex, France.
Br J Dermatol. 2002 Jul;147(1):41-7. doi: 10.1046/j.1365-2133.2002.04804.x.
Most published series of basal cell carcinomas (BCCs) do not take into account the histopathological subtype. Recent studies suggest that the nodular and superficial types could be induced by different causal factors.
To analyse the three major subtypes of BCC with regard to sex, age and anatomical distribution.
We retrospectively included all cases of BCC diagnosed at a single centre of dermatopathology during 1967-96. The diagnosis and subtype (nodular, superficial, morphoeiform) were confirmed by two dermatopathologists. Gender, age at excision, number of tumours and location were recorded, and analysed by histopathological subtype.
We recorded 13 457 cases in 10 245 patients (M/F ratio 0.92) of mean age 65 years. Of the BCCs, 78.7% were nodular, 15.1% superficial and 6.2% morphoeiform. Nodular tumours occurred at a mean age of 66.3 years, whereas superficial tumours were excised earlier (63.0 years) and more frequently in women (M/F ratio 0.96). Patients with morphoeiform BCC had a mean age of 65.8 years and were predominantly women (M/F ratio 0.73). Both nodular and morphoeiform types predominated on the head (89.6% and 94.8%), whereas the trunk was the most common location for the superficial type (45.9%). Superficial carcinomas were predominantly located on the head in women (44.8% vs. 34.7% in men), whereas they predominated on the trunk in men (49.9% vs. 42% in women). Tumours of the trunk were excised earlier than those of the face, whatever their histological subtype, in both men and women.
This is the largest series of BCCs in the literature, and shows striking differences in anatomical distribution, sex and mean age according to histological type. The results suggest that the tumours of the trunk, and not only those of the superficial type, could represent a particular subtype of BCC. The analysis also suggests that the hypothesis of chronic vs. intermittent sun exposure cannot be simply extrapolated to BCC. Other causal factors, such as a genetic predisposition, could be involved in the development of carcinomas located on the trunk.
大多数已发表的基底细胞癌（BCCs）系列研究未考虑组织病理学亚型。最近的研究表明，结节型和表浅型可能由不同的致病因素诱发。
分析BCC的三种主要亚型在性别、年龄和解剖分布方面的情况。
我们回顾性纳入了1967年至1996年在单一皮肤病理学中心诊断的所有BCC病例。诊断和亚型（结节型、表浅型、浸润型）由两名皮肤病理学家确认。记录性别、切除时的年龄、肿瘤数量和位置，并按组织病理学亚型进行分析。
我们记录了10245例患者中的13457例病例（男/女比例为0.92），平均年龄为65岁。在BCC中，78.7%为结节型，15.1%为表浅型，6.2%为浸润型。结节型肿瘤的平均发病年龄为66.3岁，而表浅型肿瘤切除较早（63.0岁），且女性更为常见（男/女比例为0.96）。浸润型BCC患者的平均年龄为65.8岁，且以女性为主（男/女比例为0.73）。结节型和浸润型在头部均占主导（分别为89.6%和94.8%），而躯干是表浅型最常见的部位（45.9%）。表浅型癌在女性中主要位于头部（44.8%，男性为34.7%），而在男性中主要位于躯干（49.9%，女性为42%）。无论组织学亚型如何，男性和女性躯干部位的肿瘤切除时间均早于面部肿瘤。
这是文献中最大的BCC系列研究，显示出根据组织学类型在解剖分布、性别和平均年龄方面存在显著差异。结果表明，躯干部位的肿瘤，不仅是表浅型肿瘤，可能代表BCC的一种特殊亚型。分析还表明，慢性与间歇性阳光照射的假设不能简单地外推至BCC。其他致病因素，如遗传易感性，可能与躯干部位癌的发生有关。
