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浸润性基底细胞癌局部侵袭的预测因子:肿瘤芽出优于 WHO 分型。

Predictors of Local Invasion in Infiltrative Basal Cell Carcinoma: Tumour Budding Outperforms the WHO Subtyping.

机构信息

Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain; Affiliation Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain.

Affiliation Department of Dermatology, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Affiliation Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

Acta Derm Venereol. 2024 Jul 2;104:adv40172. doi: 10.2340/actadv.v104.40172.

Abstract

Tumour budding (TB) correlates with increased local invasion in various neoplasms. Certain basal cell carcinomas (BCCs) exhibit local aggressiveness. Detecting adverse prognostic factors in partial biopsies could aid in identifying cases with heightened local risk. The absolute number of TB (≤ 3 tumour cells) in excision specimens of 271 infiltrative BCCs (0: absent; 1: 1-2 foci; 2: ≥ 3 foci; 3: ≥ 10 foci), the histopathological subtype and depth of infiltration, perineural invasion, and other histological features were evaluated. A significant correlation was found between TB and both depth of infiltration (rho 0.445, p < 0.001) and perineural invasion (p = 0.009). In the multivariate analysis of depth and perineural invasion (multiple regression, stepwise), TB was identified as a significant covariate together with diameter, inflammation, and perineural invasion for the former, and depth for the latter. Conversely, no correlation existed between the WHO histological subtypes (infiltrating, sclerosing, and micronodular), and depth of infiltration or perineural invasion. This study demonstrates the value of TB as a biomarker for local invasiveness in BCC. In routine practice, a count of ≥ 3 TB foci in lesions incompletely excised or with narrow tumour-free surgical margins would be a straightforward and reproducible method to guide BCC treatment.

摘要

肿瘤芽(TB)与各种肿瘤的局部侵袭增加相关。某些基底细胞癌(BCC)表现出局部侵袭性。在部分活检中检测不良预后因素可以帮助识别局部风险较高的病例。在 271 例浸润性 BCC 切除标本中评估了 TB(≤3 个肿瘤细胞)的绝对数量(0:无;1:1-2 个病灶;2:≥3 个病灶;3:≥10 个病灶)、组织病理学亚型和浸润深度、神经周围侵犯以及其他组织学特征。TB 与浸润深度(rho 0.445,p<0.001)和神经周围侵犯(p=0.009)呈显著相关。在浸润深度和神经周围侵犯的多变量分析(多元回归,逐步)中,TB 与直径、炎症和神经周围侵犯一起被确定为前者的重要协变量,与后者的深度相关。相反,WHO 组织学亚型(浸润性、硬化性和微结节性)与浸润深度或神经周围侵犯之间没有相关性。本研究表明 TB 作为 BCC 局部侵袭性的生物标志物具有价值。在常规实践中,对于不完全切除或肿瘤无手术切缘狭窄的病变,计数≥3 个 TB 病灶将是一种简单且可重复的方法,可以指导 BCC 治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c590/11247513/0a5800d5a902/ActaDV-104-40172-g001.jpg

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