Wortsman X, Vergara P, Castro A, Saavedra D, Bobadilla F, Sazunic I, Zemelman V, Wortsman J
Departments of Radiology and Dermatology, IDIEP, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile.
J Eur Acad Dermatol Venereol. 2015 Apr;29(4):702-7. doi: 10.1111/jdv.12660. Epub 2014 Sep 8.
Basal cell carcinoma (BCC) recurrences, especially in the facial region, represent a complex cosmetic problem. To date the possibility of predicting recurrence is supported solely by the histologic subtype.
To evaluate the relationship between BCC histologic subtypes linked to high and low risk of recurrence and the presence of hyperechoic spots on sonography.
Retrospective analysis of the pre-surgical ultrasound examinations of primary BCC tumours with visualization and counting of intra-tumoural hyperechoic spots. The data were then correlated with the corresponding histologic subtype.
Thirty one patients with histologically proven BCC were included in the study. Hyperechoic spots were detected in all cases and there was a positive, statistically significant association between hyperechoic spots count and high recurrence risk histologic subtypes. Higher hyperechoic spots count was found in the recurrence-prone micronodular, sclerosing variant and morpheiform BCC subtypes. Low risk and high risk of recurrence showed a significant difference on the mean hyperechoic spots count of 5.5 (range: 3-25) and 8 (4-81). A cut-off point ≥7 hyperechoic spots presented a sensitivity of 79% and specificity of 53% for predicting the high risk of recurrence subtypes.
The presence and count of hyperechoic spots within BCC lesions may help predicting the high risk of recurrence histologic subtypes.
基底细胞癌（BCC）复发，尤其是在面部区域，是一个复杂的美容问题。迄今为止，预测复发可能性的依据仅为组织学亚型。
评估与复发高风险和低风险相关的BCC组织学亚型与超声检查中高回声斑点的存在之间的关系。
对原发性BCC肿瘤的术前超声检查进行回顾性分析，观察并计数肿瘤内的高回声斑点。然后将数据与相应的组织学亚型进行关联。
31例经组织学证实为BCC的患者纳入研究。所有病例均检测到高回声斑点，高回声斑点计数与高复发风险组织学亚型之间存在显著的正相关。在易复发的微结节型、硬化型和硬斑病样BCC亚型中发现较高的高回声斑点计数。复发低风险组和高风险组的平均高回声斑点计数分别为5.5（范围：3 - 25）和8（4 - 81），差异有统计学意义。以≥7个高回声斑点为界值，预测复发高风险亚型的敏感性为79%，特异性为53%。
BCC病变内高回声斑点的存在和计数可能有助于预测复发高风险的组织学亚型。
