Department of Flight Medicine, Wilford Hall Ambulatory Surgical Center, San Antonio, Texas.
Department of Pathology, San Antonio Military Medical Center, San Antonio, Texas.
J Am Acad Dermatol. 2018 Jul;79(1):42-46. doi: 10.1016/j.jaad.2017.12.071. Epub 2018 Jan 4.
Pathology reports of basal cell carcinoma (BCC) biopsies often contain comments of positive or negative margins, with only 1%-2% of the margin evaluated. The negative predictive value (NPV) of biopsy margin status on residual BCC is unknown.
The purpose of this study was to determine the NPV of BCC biopsy margin status on the absence of residual BCC in the corresponding excision.
From our institution's archives, we collected BCC biopsies with negative margin readings that had subsequent excisions. For excisions read as negative for residual BCC, the excision blocks were sectioned at 150-μm intervals until exhausted.
We collected 143 cases that met criteria; 34 (24%) were found to contain residual BCC in the corresponding excision leading to a NPV of 76%; in 31 of 34 (91%) of these cases, the residual histologic subtype was superficial.
Our sectioning technique did not evaluate 100% of the excision specimens.
Negative margins in a BCC biopsy are a poor predictor of residual disease in the patient. We recommend that clinicians treat these lesions, and that pathologists who comment on margin status of BCC biopsies consider adding a caveat to reflect these findings.
基底细胞癌（BCC）活检的病理报告通常包含边缘阳性或阴性的评论，只有 1%-2%的边缘进行评估。活检边缘状态对残留 BCC 的阴性预测值（NPV）尚不清楚。
本研究旨在确定 BCC 活检边缘状态对相应切除中无残留 BCC 的 NPV。
我们从机构档案中收集了边缘读为阴性且随后进行了切除的 BCC 活检。对于读为无残留 BCC 的切除物，将切除块以 150-μm 的间隔进行切片，直到用尽。
我们收集了符合标准的 143 例病例；其中 34 例（24%）在相应切除中发现有残留 BCC，导致 NPV 为 76%；在这 34 例中的 31 例（91%）中，残留的组织学亚型为浅表型。
我们的切片技术并未评估 100%的切除标本。
BCC 活检中的阴性边缘是患者残留疾病的不良预测指标。我们建议临床医生对这些病变进行治疗，而对 BCC 活检边缘状态发表评论的病理学家应考虑添加警告以反映这些发现。
