Leibovitch Igal, Huilgol Shyamala C, Selva Dinesh, Richards Shawn, Paver Robert
Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia.
J Am Acad Dermatol. 2005 Sep;53(3):458-63. doi: 10.1016/j.jaad.2005.04.089.
Perineural invasion (PNI) is an important factor may possibly influence the aggressiveness of basal cell carcinoma (BCC).
Our purpose was to evaluate the incidence, features, and outcomes of BCC with PNI in patients treated with Mohs micrographic surgery (MMS).
This prospective, multicenter case series included all patients in Australia treated with MMS for BCC with PNI, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. The parameters recorded were patient demographics, reason for referral, duration of tumor, site, preoperative tumor size, recurrence before MMS, histologic subtypes, postoperative defect size, and recurrence at 5 years after MMS.
Two-hundred eighty-three patients were diagnosed with PNI. Most cases occurred in male patients (61%; P = .006) and in previously recurrent tumors (60.4%; P < .001). The infiltrating, morpheic, and basosquamous subtypes were more likely to be associated with PNI (P < .0001). Tumor sizes before excision and postoperative defect sizes were significantly larger in cases with PNI compared with cases with no PNI (P < .001 for both parameters), as was the mean number of Mohs excision levels. Seventy-eight patients completed a 5-year follow-up period after MMS, and 6 of them (7.7%) were diagnosed with recurrence.
Data were missing for some outcome measures.
PNI is an uncommon feature of BCC. When present, PNI is associated with larger, more aggressive tumors, and the risk of 5-year recurrence is higher. This emphasizes the importance of tumor excision with margin control and long-term patient monitoring.
神经周围浸润（PNI）是一个可能影响基底细胞癌（BCC）侵袭性的重要因素。
我们的目的是评估接受莫氏显微外科手术（MMS）治疗的伴有PNI的BCC患者的发病率、特征和预后。
这项前瞻性、多中心病例系列研究纳入了1993年至2002年间在澳大利亚接受MMS治疗伴有PNI的BCC的所有患者，这些患者由澳大利亚皮肤与癌症基金会进行监测。记录的参数包括患者人口统计学资料、转诊原因、肿瘤持续时间、部位、术前肿瘤大小、MMS术前复发情况、组织学亚型、术后缺损大小以及MMS术后5年的复发情况。
283例患者被诊断为PNI。大多数病例发生在男性患者中（61%；P = 0.006）以及既往复发的肿瘤中（60.4%；P < 0.001）。浸润性、硬斑病样和基底鳞状细胞亚型更有可能与PNI相关（P < 0.0001）。与无PNI的病例相比，伴有PNI的病例切除前的肿瘤大小和术后缺损大小显著更大（两个参数的P均 < 0.001），莫氏切除层数的平均数也是如此。78例患者在MMS后完成了5年的随访期，其中6例（7.7%）被诊断为复发。
一些结局指标的数据缺失。
PNI是BCC的一个不常见特征。当存在PNI时，它与更大、更具侵袭性的肿瘤相关，5年复发风险更高。这强调了肿瘤切除并控制切缘以及长期患者监测的重要性。
