Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2020 Apr 30;10(1):7387. doi: 10.1038/s41598-020-64391-9.
Asian population is a low-risk group for basal cell carcinoma (BCC) and there is little data available in this setting. Sun-exposed BCC (SEBCC) may possess a different pathogenic mechanism from non-sun-exposed BCC (NSEBCC). To compare the histopathological profiles and outcomes between SEBCC and NSEBCC, and to assess the risk factors for tumor recurrences. Retrospective cohort study on 372 patients with pathologically diagnosed BCC from January 1, 1990 to August 31, 2017. Data were derived from a single medical center in Taiwan. SEBCC presented with higher Clark level and more high-risk factors for recurrence than NSEBCC. Nodular, micronodular, infiltrating/mixed infiltrating, basosquamous, and adenoid types were predominant in SEBCC, as superficial type in NSEBCC. Risk factors for recurrence included infiltrating/mixed-infiltrating subtypes and synchronous basosquamous cell carcinoma. No recurrence events were observed in NSEBCC. Our study showed an acceptable recurrence rate (4.2%) of the whole population after excision even under a smaller surgical margin width than suggested by current guidelines. SEBCC had a higher recurrence rate with a significantly different tumor characteristic from NSEBCC and a greater tumor depth than NSEBCC. A wider surgical margin in SEBCC than NSEBCC is suggested.
亚洲人群患基底细胞癌 (BCC) 的风险较低，而针对这一人群的相关数据却十分有限。日光暴露部位的 BCC（SEBCC）可能与非日光暴露部位的 BCC（NSEBCC）具有不同的发病机制。本研究旨在比较 SEBCC 和 NSEBCC 的组织病理学特征和转归，并评估肿瘤复发的相关风险因素。
这是一项回顾性队列研究，纳入了 1990 年 1 月 1 日至 2017 年 8 月 31 日期间在台湾某单一医疗中心经病理诊断为 BCC 的 372 例患者。SEBCC 的 Clark 分级更高，且具有更多的复发高危因素。与 NSEBCC 相比，SEBCC 以结节型、微结节型、浸润型/混合浸润型、基底鳞状细胞癌和腺样型为主，而 NSEBCC 以浅表型为主。复发的风险因素包括浸润型/混合浸润型和同步发生的基底鳞状细胞癌。NSEBCC 无复发事件。
本研究结果显示，SEBCC 的复发率（4.2%）高于 NSEBCC，且 SEBCC 的肿瘤特征与 NSEBCC 明显不同，肿瘤深度大于 NSEBCC。即使手术切缘宽度小于目前指南建议的范围，经完整切除后，整个研究人群的复发率仍处于可接受水平。因此，SEBCC 建议采用比 NSEBCC 更宽的手术切缘。
