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[原位残留基底细胞瘤复发与自发消退的定量分析]

[Quantitative analysis of recurrence and spontaneous regression of basalioma parts left in situ].

作者信息

Breuninger H, Pesch M, Dietz K, Rassner G

机构信息

Universitäts-Hautklinik, Tübingen.

出版信息

Hautarzt. 1992 Sep;43(9):561-5.

PMID:1399601
Abstract

To some extent, parts of basalomas found remaining in situ following tumour excision tend to spontaneous regression. This is a well-known phenomenon and has significance for the recurrence of incompletely excised tumors. The present study involved a quantitative investigation of the relationship between recurrence and spontaneous regression. Following precisely defined excision of basalomas, the entire exterior of the excised material was examined by contrast microscopy in HE-stained paraffin sections (3-dimensional histology). Whenever tumour outgrowths were found, it was possible to document exactly their type, localization, extent, and depth of invasion. In 66 such cases no follow-up operation was performed, but only a follow-up examination after a minimum of 31 and a maximum of 113 months (average: 60 months). Only 50% of these undisturbed tumour outgrowths resulted in a recurrence during the follow-up period. A very high rate of spontaneous regression (71%) was found among the solid tumour outgrowths, but a significantly lower rate (19%) among the fibrosing tumours. Moreover, regression was dependent on the tumour remnant's mass and the clinical diameter of the tumour removed. It was independent of the depth of infiltration. Although the rate of spontaneous regression of tumour outgrowths persisting after therapy is relatively high, it cannot be predicted in individual cases. It is not possible to be certain that tumour removal has been achieved unless micrographic surgery has been continued until complete absence of tumour is proved. In all procedures that are not subsequently monitored, an unacceptably high rate of recurrence must be expected, especially in the case of fibrosing basaloma. This is commented on at length.

摘要

在一定程度上,肿瘤切除后残留原位的基底细胞瘤部分往往会自发消退。这是一个众所周知的现象,对切除不完全的肿瘤复发具有重要意义。本研究对复发与自发消退之间的关系进行了定量调查。在对基底细胞瘤进行精确界定的切除后,通过对苏木精-伊红染色石蜡切片(三维组织学)进行对比显微镜检查,对切除材料的整个外部进行检查。每当发现肿瘤向外生长时,就能够准确记录其类型、定位、范围和浸润深度。在66例此类病例中,未进行后续手术,仅在至少31个月至最多113个月(平均:60个月)后进行了随访检查。在这些未受干扰的肿瘤向外生长中,只有50%在随访期间导致复发。在实性肿瘤向外生长中发现自发消退率非常高(71%),但在纤维化肿瘤中自发消退率明显较低(19%)。此外,消退取决于肿瘤残余的大小和切除肿瘤的临床直径。它与浸润深度无关。尽管治疗后持续存在的肿瘤向外生长的自发消退率相对较高,但在个别病例中无法预测。除非显微手术持续进行直至证明完全没有肿瘤,否则无法确定已实现肿瘤切除。在所有后续未进行监测的手术中,必须预期有不可接受的高复发率,尤其是在纤维化基底细胞瘤的情况下。对此进行了详细评论。

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