Suppa M, Fontaine M, Dejonckheere G, Cinotti E, Yélamos O, Diet G, Tognetti L, Miyamoto M, Orte Cano C, Perez-Anker J, Panagiotou V, Trepant A L, Monnier J, Berot V, Puig S, Rubegni P, Malvehy J, Perrot J L, Del Marmol V
Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
J Eur Acad Dermatol Venereol. 2021 May;35(5):1099-1110. doi: 10.1111/jdv.17078. Epub 2020 Dec 29.
Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT.
To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes.
Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes.
Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules.
This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.
基底细胞癌（BCC）的早期诊断和亚型分类对于降低发病率和优化治疗至关重要。现有的诊断策略在区分BCC与临床模仿者方面已取得良好的准确性，但在鉴别BCC亚型方面表现较差。线场共聚焦光学相干断层扫描（LC-OCT）是一种能够结合反射共聚焦显微镜和OCT技术优势的新技术。
识别和描述与BCC相关的LC-OCT标准，并探讨它们与BCC亚型的关联。
在手术切除前，使用手持式LC-OCT设备对基底细胞癌进行成像。三名观察者对LC-OCT图像进行回顾性评估，以确定是否存在BCC标准。使用多变量逻辑回归模型来寻找BCC亚型的独立预测因素。
纳入了89例经组织病理学证实的BCC，其中66例（74.2%）为纯亚型[浅表性BCC（sBCC）：19/66（28.8%）；结节性BCC（nBCC）：31/66（47.0%）；浸润性BCC（iBCC）：16/66（24.2%）]。小叶、血管以及表皮/小叶内的小明亮细胞是BCC最常见的标准。与sBCC独立相关的LC-OCT标准为存在半球形小叶、小叶与表皮无分离、间质无拉伸；与nBCC相关的标准为存在大的小叶、小叶与表皮无连接；与iBCC相关的标准为存在分支状小叶。
这是第一项描述LC-OCT检查下BCC特征的研究。我们提出了形态学标准，这可能对BCC的诊断、亚型分类及其治疗管理有潜在的帮助。未来需要进一步研究来评估这些假设。
