Rubino C, Soggiu D, Farace F, Lissia M, Alfano C, Campus G V
Plastic Surgery-Burn Unit, University of Sassari, Sassari, Italy.
Acta Chir Plast. 2004;46(4):110-4.
Non-melanoma skin cancer (NMSC) is the most common type of skin cancer. Important controversial issues are the need for incisional biopsies, surgical margin, and timing of follow-up.
A retrospective study was undertaken on 2544 lesions. Accuracy of diagnosis and prevalence of incomplete excision were evaluated, comparing clinical and histological diagnosis using chi2 tests with Yates' correction. Kaplan-Meier recurrence graphs have been obtained.
Lesions were correctly diagnosed in 94% of basal cell carcinomas (BCC) and in 69% of squamous cell carcinomas (SCC) (p < 0.001). Positive margins on pathological examination were 6.6% for BCC and 6.8% for SCC. A significant difference for incomplete excision has been found for BCC in the face (p < 0.001). Kaplan-Meier survival curves showed a different pattern for BCC and SCC.
On the basis of our data, if clinical diagnosis is BCC, excision and reconstruction may be undertaken without an incisional biopsy. Alternatively, if clinical diagnosis is SCC, it is advisable to consider an incisional biopsy, before definitive surgical treatment.
非黑色素瘤皮肤癌（NMSC）是最常见的皮肤癌类型。重要的争议问题包括是否需要进行切开活检、手术切缘以及随访时机。
对2544个病灶进行了回顾性研究。评估诊断的准确性和不完全切除的发生率，使用带有Yates校正的卡方检验比较临床诊断和组织学诊断。获得了Kaplan-Meier复发图。
基底细胞癌（BCC）中94%的病灶诊断正确，鳞状细胞癌（SCC）中69%的病灶诊断正确（p < 0.001）。BCC病理检查切缘阳性率为6.6%，SCC为6.8%。面部BCC的不完全切除存在显著差异（p < 0.001）。Kaplan-Meier生存曲线显示BCC和SCC的模式不同。
根据我们的数据，如果临床诊断为BCC，可在不进行切开活检的情况下进行切除和重建。或者，如果临床诊断为SCC，在确定性手术治疗前考虑进行切开活检是可取的。
