Nicoletti Giovanni, Tresoldi Marco Mario, Malovini Alberto, Prigent Sebastien, Agozzino Manuela, Faga Angela
Plastic and Reconstructive Surgery, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Advanced Technologies for Regenerative Medicine and Inductive Surgery Research Center, University of Pavia, Pavia, Italy.
Clin Med Insights Oncol. 2018 Dec 7;12:1179554918817328. doi: 10.1177/1179554918817328. eCollection 2018.
This study aims at the identification of the distribution of basal cell carcinomas (BCCs) in the auricle in correlation with the currently most credited sites of the embryonic fusion planes of the auricle.
An overall number of 69 patients with 72 BCCs of the auricle were enrolled in the study over a period of 14 years, from June 2003 to October 2017. All the cases underwent medical preoperative digital photography and the specific location of each BCC was coded on an original full-size anatomical diagram of the auricle derived from the reports by Streeter, Wood-Jones, Park, Porter, and Minoux showing the currently most credited sites of the embryonic fusion planes arbitrarily featured as two 5-mm-wide ribbon-like areas: (1) the hyoid-mandibular fusion plane (HM-FP) running from the upper margin of the tragus toward the concha and then deflecting toward the lower margin of the tragus and (2) the free ear fold-hyoid fusion plane (FEFH-FP) running from the cranial-most portion of the helix to the mid-portion of the ascending helix. The latter fusion planes were comprehensively termed embryological fusion planes (EFP) while all of the remaining surface of the auricle was comprehensively termed non-fusion area (NFA). The surfaces of all of the latter areas were calculated using the ImageJ software.
According to our data, the greatest number of BCCs was observed within the currently most credited sites of the embryonic fusion planes of the auricle. The latter sites displayed a 12-fold increased tumor incidence in comparison with the remaining surface of the ear.
A correspondence between the sites of onset of BCCs and the sites of merging and/or fusion of embryonal processes was demonstrated in the auricle. Therefore, the latter sites might be considered as high-risk areas for the development of a BCC. Such an evidence provides further support to the hypothesis of an embryological pathogenesis of BCC.
本研究旨在确定耳廓基底细胞癌（BCC）的分布情况，并将其与目前最受认可的耳廓胚胎融合平面部位相关联。
在2003年6月至2017年10月的14年期间，共纳入了69例患有72处耳廓基底细胞癌的患者。所有病例均在术前进行了医学数码摄影，每个基底细胞癌的具体位置在一张源自斯特里特、伍德 - 琼斯、帕克、波特和米努克斯报告的耳廓原始全尺寸解剖图上进行编码，该图显示了目前最受认可的胚胎融合平面部位，这些部位被任意设定为两个5毫米宽的带状区域：（1）舌骨 - 下颌融合平面（HM - FP），从耳屏上缘朝向耳甲，然后转向耳屏下缘；（2）游离耳褶 - 舌骨融合平面（FEFH - FP），从耳轮最上端延伸至耳轮上缘中部。后一个融合平面被统称为胚胎融合平面（EFP），而耳廓其余所有表面被统称为非融合区域（NFA）。所有这些区域的表面积均使用ImageJ软件进行计算。
根据我们的数据，在目前最受认可的耳廓胚胎融合平面部位观察到的基底细胞癌数量最多。与耳廓其余表面相比，这些部位的肿瘤发生率增加了12倍。
在耳廓中证实了基底细胞癌的发病部位与胚胎发育过程的合并和/或融合部位之间存在对应关系。因此，这些部位可能被视为基底细胞癌发生的高危区域。这一证据为基底细胞癌胚胎发病机制的假说提供了进一步支持。
