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眼部周围基底细胞癌亚型活检的准确性

Accuracy of Biopsy in Subtyping Periocular Basal Cell Carcinoma.

作者信息

Sun Michelle T, Wu Albert, Huilgol Shyamala C, Selva Dinesh

机构信息

*South Australian Institute of Ophthalmology, and †Department of Dermatology, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Ophthalmic Plast Reconstr Surg. 2015 Nov-Dec;31(6):449-51. doi: 10.1097/IOP.0000000000000372.

Abstract

PURPOSE

To determine the accuracy of initial biopsy in the diagnosis of basal cell carcinoma (BCC) histologic subtype.

METHODS

Retrospective histopathologic review of patients with a diagnosis of primary periocular BCC from 2006 to 2013 inclusive.

RESULTS

A total of 174 primary BCCs were identified. BCCs were classified as nodular, superficial, or aggressive (including mixed cases with an aggressive component). Punch biopsies were used in 41% of cases, while the remaining patients underwent shave or incision biopsies. The final histologic subtypes at excision were nodular (59%), superficial (7%), nodular and superficial (7%), and aggressive (51%). The overall concordance between the BCC subtype identified in the biopsy specimen and the subsequent excision specimen was 54%. In total, there were 51 cases (29%) of BCC, which included aggressive subtypes, of which 52% of initial biopsies failed to detect an aggressive component. There were 45 cases (26%) of mixed BCC, and an aggressive histologic subtype was present in 73% of these cases.

CONCLUSIONS

The accuracy of initial biopsy for BCC histologic subtype at excision is highest for nodular BCC. For aggressive BCC, biopsy was able to detect the aggressive component in only 48% of cases. This may have implications for choice of treatment modality.

摘要

目的

确定初次活检在基底细胞癌(BCC)组织学亚型诊断中的准确性。

方法

对2006年至2013年(含)诊断为原发性眼周BCC的患者进行回顾性组织病理学检查。

结果

共识别出174例原发性BCC。BCC分为结节型、表浅型或侵袭型(包括伴有侵袭成分的混合病例)。41%的病例采用了钻孔活检,其余患者接受了刮除或切除活检。切除时的最终组织学亚型为结节型(59%)、表浅型(7%)、结节型和表浅型(7%)以及侵袭型(51%)。活检标本中确定的BCC亚型与随后切除标本之间的总体一致性为54%。总共有51例(29%)BCC病例,其中包括侵袭型亚型,其中52%的初次活检未能检测到侵袭成分。有45例(26%)混合性BCC病例,其中73%存在侵袭性组织学亚型。

结论

对于结节型BCC,初次活检对切除时BCC组织学亚型的诊断准确性最高。对于侵袭型BCC,活检仅在48%的病例中能够检测到侵袭成分。这可能对治疗方式的选择有影响。

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