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肛周基底细胞癌——基于真实世界数据的系统评价与Meta分析

Perianal Basal Cell Carcinoma-A Systematic Review and Meta-Analysis of Real-World Data.

作者信息

Tsai Tzong-Yun, Liao Chun-Kai, Zhang Bang-Yan, Huang Yen-Lin, Tsai Wen-Sy, You Jeng-Fu, Yeh Chien-Yuh, Hsieh Pao-Shiu

机构信息

Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City 33305, Taiwan.

College of Medicine, Chang Gung University, Taoyuan City 33305, Taiwan.

出版信息

Diagnostics (Basel). 2023 May 8;13(9):1650. doi: 10.3390/diagnostics13091650.

Abstract

(1) Background: BCC is a sporadic disease that develops in areas of the skin not exposed to the sun. Perianal BCC, which occurs in the anorectal region, accounts for less than 0.2% of all BCC cases. There have been only a few reported cases of the disease, with fewer than 200 cases reported in total. Given the diagnostic challenges and potential for misdiagnosis, we conducted a systematic review of perianal basal cell carcinoma using real-world data to provide comprehensive and detailed information on the disease. (2) Methods: The study was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2020. Patients' clinical pathologic features, tumor characteristics, treatment modalities, and outcomes were presented. (3) Results: The results of 41 studies involving 140 patients were analyzed. The most common symptoms reported by patients at presentation were anorectal bleeding, pain, and pruritus. Ulceration was the most frequently observed tumor characteristic. The majority of patients underwent local excision as their primary treatment, with only eight patients experiencing a recurrence. Our analysis did not reveal any statistically significant differences in the outcomes of different treatment modalities. (4) Conclusions: Identifying perianal BCC poses a significant challenge as it closely resembles other anal diseases, thereby making it difficult to differentiate between the different conditions. However, a wide local excision with clear margins is considered an effective treatment option for most patients. Alternative treatments, such as radiotherapy, may be recommended for patients who are unable to undergo surgery.

摘要

(1) 背景:基底细胞癌(BCC)是一种散发性疾病,发生于未暴露于阳光的皮肤部位。肛周基底细胞癌发生于肛管直肠区域,占所有基底细胞癌病例的比例不到0.2%。该病仅有少数病例报道,总计报道病例数不足200例。鉴于诊断存在挑战且有误诊的可能性,我们利用真实世界数据对肛周基底细胞癌进行了系统评价,以提供关于该疾病全面而详细的信息。(2) 方法:本研究依据2020年系统评价与Meta分析的首选报告项目(PRISMA)指南进行报告。呈现了患者的临床病理特征、肿瘤特点、治疗方式及结局。(3) 结果:分析了涉及140例患者的41项研究结果。患者就诊时最常见的症状为肛管直肠出血、疼痛和瘙痒。溃疡是最常观察到的肿瘤特征。大多数患者接受局部切除作为主要治疗,仅有8例患者复发。我们的分析未发现不同治疗方式的结局存在任何统计学显著差异。(4) 结论:识别肛周基底细胞癌是一项重大挑战,因为它与其他肛门疾病极为相似,从而难以区分不同情况。然而,切缘清晰的广泛局部切除被认为是大多数患者的有效治疗选择。对于无法接受手术的患者,可能推荐放疗等替代治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d31/10178443/c274d622dc9e/diagnostics-13-01650-g001.jpg

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