Chinem Valquiria Pessoa, Miot Hélio Amante
Department of Dermatology and Radiotherapy, Faculty of Medicine of Botucatu, Sao Paulo State University (FMB-UNESP), Botucatu, SP, Brasil.
An Bras Dermatol. 2011 Mar-Apr;86(2):292-305. doi: 10.1590/s0365-05962011000200013.
Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30% and 75% of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma.
基底细胞癌是人类最常见的恶性肿瘤,在过去几十年中其发病率有所上升。其高发病率给卫生系统带来了沉重负担,使该疾病成为一个公共卫生问题。尽管死亡率较低且转移情况罕见,但肿瘤可能具有局部侵袭性,治疗后会复发,导致严重的发病率。暴露于紫外线辐射是与其病因相关的主要环境风险因素。然而,也描述了其他风险因素,如浅色皮肤光型、高龄、皮肤癌家族史、浅色眼睛和金发、儿童期雀斑以及免疫抑制。职业性阳光暴露、农村劳动和年轻时晒伤等行为因素也起作用。30%至75%的散发性病例与patched刺猬基因突变有关,但也描述了其他基因变化。该肿瘤通常与慢性阳光暴露相关的皮肤病变同时出现,如光化性角化病、日光性雀斑和面部毛细血管扩张。基底细胞癌的预防基于对风险因素的了解、早期诊断和治疗,以及采取特定措施,特别是在易感人群中。作者对基底细胞癌的流行病学进行了综述。