Goh Boon Kee, Ang Por, Wu Ying Juan, Goh Chee Leok
National Skin Centre and Clinical Trials and Epidemiology Research Unit, Singapore.
Int J Dermatol. 2006 May;45(5):561-4. doi: 10.1111/j.1365-4632.2004.02515.x.
Most published series of basal cell carcinomas (BCCs) are based on Caucasian populations. Very little is known about the characteristics of incompletely excised BCCs in Asians.
This study examines the characteristics of BCCs in Asian residents in Singapore, and compares incompletely with completely excised tumors after conventional surgical excision.
A retrospective study was conducted using the case records of patients who had a primary BCC excised at the National Skin Centre between 1991 and 1995.
A total of 185 histologically confirmed BCCs were recorded in 166 patients (male to female ratio, 0.95; mean age, 70.9 years). The highest proportion (27.1%) was in the 81-90-year age group. Compared with census data, a significantly higher proportion of patients with BCCs were Chinese (P < 0.001). The tumors averaged 12.0 mm in diameter and the majority (84.3%) were located on the head and neck. In 28 lesions (15.1%), the tumors were incompletely excised, with those on the nose and nasolabial folds being most frequent. Incompletely excised BCCs were more likely than completely excised lesions to be located on the mid-face and trunk (P = 0.003), but there was no significant correlation with tumor size, tumor duration, or patient age, race, and gender. The overall recurrence rate was 1.6% over a mean follow-up time of 74 months.
BCCs are more common amongst Chinese in Singapore and occur chiefly in the elderly. Conventional surgical excision with margin control achieves a satisfactory tumor clearance rate of 84.9%. Incomplete excision is associated with tumor location on the mid-face and trunk rather than tumor size or duration.
大多数已发表的基底细胞癌（BCC）系列研究基于白种人群体。对于亚洲人不完全切除的基底细胞癌的特征了解甚少。
本研究调查新加坡亚洲居民中基底细胞癌的特征，并比较传统手术切除后不完全切除与完全切除肿瘤的情况。
采用1991年至1995年在国家皮肤中心切除原发性基底细胞癌的患者病历进行回顾性研究。
166例患者共记录到185例经组织学确诊的基底细胞癌（男女比例为0.95；平均年龄70.9岁）。81 - 90岁年龄组的比例最高（27.1%）。与人口普查数据相比，基底细胞癌患者中中国人的比例显著更高（P < 0.001）。肿瘤平均直径为12.0毫米，大多数（84.3%）位于头颈部。28个病灶（15.1%）的肿瘤切除不完全，其中鼻子和鼻唇沟处的最为常见。不完全切除的基底细胞癌比完全切除的病灶更可能位于面中部和躯干（P = 0.003），但与肿瘤大小、肿瘤持续时间或患者年龄、种族和性别无显著相关性。平均随访74个月期间，总体复发率为1.6%。
基底细胞癌在新加坡的中国人中更为常见，主要发生在老年人中。通过控制切缘的传统手术切除实现了令人满意的肿瘤清除率，为84.9%。不完全切除与肿瘤位于面中部和躯干有关，而非肿瘤大小或持续时间。
