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基底细胞癌切除不完全:362例连续病例的发生率及相关因素

Incomplete excision of basal cell carcinoma: rate and associated factors among 362 consecutive cases.

作者信息

Farhi David, Dupin Nicolas, Palangié André, Carlotti Agnés, Avril Marie-Françoise

机构信息

Department of Dermatology and Venereology, AP-HP Hôpital Cochin, Université Paris V-René Descartes, Paris, France.

出版信息

Dermatol Surg. 2007 Oct;33(10):1207-14. doi: 10.1111/j.1524-4725.2007.33255.x.

Abstract

BACKGROUND

Reported rates of incomplete excision of basal cell carcinoma (BCC) range from 4% to 16.6%.

OBJECTIVE

The objective was to assess, in clinical practice, the rate and the factors associated with pathologically reported incomplete excision of BCC.

METHODS

In this retrospective monocentric study, data from all surgically excised BCCs during the year 2004 were computerized. Age, sex, number of BCC excised during the same surgical session, BCC location, pathologic types, and involvement of surgical margins were analyzed.

RESULTS

Mean age of the 284 patients was 67.4+/-14.9 (SD) years (range, 27-96 years). A total of 52.7% of the 362 BCCs were located on the face (including nose, 10%; eyelids, 4.2%; lips, 2%; and ears, 2.2%). Incomplete excisions occurred in 10.3% of the cases including 8.6% of positive lateral margins and 2.5% of positive deep margins. In the multivariate analysis, incomplete excision was independently associated with location on the nasal ala (p<.02), other parts of the nose (p=.02), and inner canthus (p=.01) and with infiltrative (p<.0001) and multifocal (p<.0001) types.

CONCLUSION

Pathologically reported incomplete excision rate was comparable to that of other studies and was significantly associated with the location on the face, particularly on the nose and inner canthus, and with infiltrative and multifocal histologic types.

摘要

背景

据报道,基底细胞癌(BCC)切除不完全的发生率在4%至16.6%之间。

目的

旨在评估临床实践中病理报告的BCC切除不完全的发生率及相关因素。

方法

在这项回顾性单中心研究中,将2004年所有手术切除的BCC数据进行了计算机化处理。分析了年龄、性别、同一次手术中切除的BCC数量、BCC位置、病理类型以及手术切缘情况。

结果

284例患者的平均年龄为67.4±14.9(标准差)岁(范围27 - 96岁)。362例BCC中,52.7%位于面部(包括鼻子,10%;眼睑,4.2%;嘴唇,2%;耳朵,2.2%)。10.3%的病例出现切除不完全,其中外侧切缘阳性占8.6%,深部切缘阳性占2.5%。多因素分析显示,切除不完全与鼻翼(p<0.02)、鼻子其他部位(p = 0.02)、内眦(p = 0.01)的位置以及浸润性(p<0.0001)和多灶性(p<0.0001)类型独立相关。

结论

病理报告的切除不完全发生率与其他研究相当,且与面部位置显著相关,尤其是鼻子和内眦,以及浸润性和多灶性组织学类型。

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