Division of Dermatology, UCLA, Los Angeles, California.
Memorial Sloan Kettering Cancer Center Dermatology Service, New York, New York.
Dermatol Surg. 2019 Nov;45(11):1345-1352. doi: 10.1097/DSS.0000000000001841.
The rate of occult invasive disease within biopsy-proven squamous cell carcinoma in situ (SCCIS) is not well defined.
To examine the rate of occult invasion in SCCIS.
An institutional-wide pathology database was retrospectively searched for "squamous cell carcinoma in situ" over a 6-year period, and the treatment modality and final pathology results were analyzed for evidence of invasion. In addition, consecutive tumor blocks from Mohs micrographic surgery (MMS) cases of SCCIS were prospectively analyzed for invasion.
The rate of occult invasion for biopsy-proven SCCIS treated with excision was 4.0% (N = 49) and for the MMS margins was 3.5% (N = 310). For the prospective MMS tumor block analysis, the rate of occult invasion was 10.1% (N = 69). No clinical factors (age, sex, location, or size) correlated with increased risk of invasion. All invasive SCCs detected were superficial and well differentiated.
The rate of occult invasion for biopsy-proven SCCIS ranged from 3.5% to 10.1%. The detected rate of invasion varies based on the method of excision and pathology processing of specimens. The rate of invasion should be considered when managing SSCIS.
活检证实的鳞状细胞原位癌（SCCIS）中隐匿性浸润的发生率尚不清楚。
检查 SCCIS 中的隐匿性浸润率。
回顾性检索了 6 年来机构范围内的病理学数据库中“鳞状细胞原位癌”，并分析了治疗方式和最终病理学结果，以寻找浸润的证据。此外，还前瞻性分析了 Mohs 显微外科手术（MMS）中 SCCIS 的连续肿瘤块是否存在浸润。
接受切除治疗的活检证实 SCCIS 的隐匿性浸润率为 4.0%（N=49），MMS 切缘的隐匿性浸润率为 3.5%（N=310）。对于前瞻性 MMS 肿瘤块分析，隐匿性浸润率为 10.1%（N=69）。没有临床因素（年龄、性别、位置或大小）与浸润风险增加相关。所有检测到的浸润性 SCC 均为表浅和高分化。
活检证实的 SCCIS 隐匿性浸润率为 3.5%至 10.1%。浸润的检出率取决于切除方法和标本的病理处理。在管理 SCCIS 时应考虑浸润率。
