Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China; Department of Medical Ultrasound & Tumor Minimally Invasive Treatment, Shanghai Tenth People's Hospital; Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Tongji University School of Medicine, Shanghai, China; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment; National Clinical Research Center for Interventional Medicine, Shanghai, China.
Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.
Ultrasound Med Biol. 2021 Oct;47(10):2910-2920. doi: 10.1016/j.ultrasmedbio.2021.06.006. Epub 2021 Jul 18.
The purpose of the study was to evaluate the value of high-frequency ultrasound (HFUS) for differentiating invasive basal cell carcinomas (BCCs) from non-invasive BCCs. We established a prediction model based on ultrasound features and validated it further. One hundred patients in the pilot cohort and another 43 in the validation cohort were evaluated. All patients underwent HFUS examinations by the same radiologist, and then were divided on the basis of pathology into invasive and non-invasive types. With respect to growth pattern, 60.5% of invasive BCCs had an irregular pattern, whereas 89.5% of non-invasive BCCs had a nodular or crawling pattern (p < 0.001). As for the layers involved, the more invasive BCCs broke through the dermis compared with non-invasive BCCs (23.3% vs. 1.8%) (p < 0.001). With respect to intralesional hyperechoic spot distribution, invasive and non-invasive BCCs tended to be clustered and absent/scattered-like, respectively (55.8% vs. 91.2%) (p < 0.001). On the basis of the aforementioned features, a prediction model was established with accuracies of 84.0% and 76.7%, respectively, in the pilot and validation cohorts. HFUS holds promise for the differentiation of the invasiveness of BCCs and is helpful in its clinical management.
本研究旨在评估高频超声（HFUS）在鉴别侵袭性基底细胞癌（BCC）与非侵袭性 BCC 中的价值。我们建立了一个基于超声特征的预测模型，并进一步进行了验证。在试点队列中评估了 100 例患者，在验证队列中评估了另外 43 例患者。所有患者均由同一位放射科医生进行 HFUS 检查，然后根据病理结果分为侵袭性和非侵袭性两种类型。在生长模式方面，60.5%的侵袭性 BCC 呈不规则模式，而 89.5%的非侵袭性 BCC 呈结节状或爬行状（p<0.001）。在涉及的层次方面，侵袭性 BCC 比非侵袭性 BCC 更易突破真皮（23.3%比 1.8%）（p<0.001）。就瘤内高回声点分布而言，侵袭性和非侵袭性 BCC 分别倾向于呈簇状和分散状（55.8%比 91.2%）（p<0.001）。基于上述特征，在试点和验证队列中，预测模型的准确率分别为 84.0%和 76.7%。HFUS 有望用于鉴别 BCC 的侵袭性，并有助于其临床管理。
