伴有神经周围浸润的基底细胞癌：再次切除神经周围浸润组织？
Basal cell carcinoma with perineural invasion: reexcision perineural invasion?
作者信息
Bechert Charles J, Stern Jere B
机构信息
Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
出版信息
J Cutan Pathol. 2010 Mar;37(3):376-9. doi: 10.1111/j.1600-0560.2009.01331.x. Epub 2009 Jul 13.
BACKGROUND
Perineural invasion (PI) in basal cell and squamous cell carcinomas, especially of the head and neck, has been reported to indicate an increased morbidity. Reexcision perineural invasion (RPI), a benign mimic of tumoral perineural invasion, may present a difficult histologic differential diagnosis.
METHODS
We surveyed the medical literature for PI occurring in basal cell carcinomas to investigate the degree to which the reported cases occurred in reexcision specimens vs. primary biopsy specimens.
RESULTS
We found large retrospective studies of 14,120 basal cell carcinomas evaluated for PI in which 310 cases of PI were identified (2.2%), and 20 sporadic case reports of basal cell carcinomas with PI. Of 310 cases of basal cell carcinoma with PI, 196 (63%) were in reexcision specimens. Of 20 sporadic reports, 17 (85%) were in reexcision specimens.
CONCLUSION
The high percentage of PI occurring in reexcision specimens vs. primary excisions may indicate that many of the reported cases of basal cell carcinomas with PI are actually examples of RPI.
背景
据报道，基底细胞癌和鳞状细胞癌（尤其是头颈部的此类癌症）中的神经周围浸润（PI）表明发病率增加。再切除时的神经周围浸润（RPI）是肿瘤性神经周围浸润的一种良性模仿表现，可能会带来困难的组织学鉴别诊断。
方法
我们查阅了医学文献中基底细胞癌发生PI的情况，以调查报告病例在再切除标本与初次活检标本中出现的比例。
结果
我们发现了对14120例基底细胞癌进行PI评估的大型回顾性研究，其中确定了310例PI病例（2.2%），以及20例基底细胞癌伴PI的散发病例报告。在310例基底细胞癌伴PI的病例中，196例（63%）出现在再切除标本中。在20例散发病例报告中，17例（85%）出现在再切除标本中。
结论
与初次切除标本相比，再切除标本中出现PI的比例较高，这可能表明许多报告的基底细胞癌伴PI病例实际上是RPI的例子。
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