Choi Esther, Oberg Martha A, Hijazi Maya, Hall Luke, Miller Kimberly A, Mehta Arjun, Capone Stephen, In Gino K
Elson S. Floyd College of Medicine Washington State University Spokane Washington USA.
Department of Pathology Los Angeles County - University of Southern California Medical Center Los Angeles California USA.
Skin Health Dis. 2024 Mar 24;4(4):e379. doi: 10.1002/ski2.379. eCollection 2024 Aug.
Basal cell carcinoma (BCC) is the most common malignancy in the United States. The majority of cases are identified in Non-Hispanic Whites (NHW) and are far less demonstrated in patients of colour (POC). However, the Hispanic population represents a large and growing proportion of the US population, and skin cancer diagnoses in Hispanics are rising. Thus, the goal of this study is to examine clinicopathologic differences between BCC in Hispanics versus NHW.
A retrospective chart review of Hispanic and NHW patients with BCC at Los Angeles County + USC Medical Center from January 2018 to March 2020 was performed. In total, 101 BCC samples from the first 100 patients identified of Hispanic ancestry, as well as 50 BCC samples identified from the first 50 patients identifying as NHW, were included for analysis. Patient characteristics (age, sex, medical history, and ethnicity), as well as tumour characteristics (location, subtype, tumour depth, and perineural invasion), were collected. We used between subjects -tests for continuous variables, and chi-square tests for categorical variables.
In total, 151 specimens were collected amongst 122 subjects (79 Hispanics and 43 NHW patients). Among NHW, the majority of patients (74.4%) were men, but among the Hispanic population, the majority (68.4%) were female ( < 0.001). Prior history of other skin cancer was more common among NHW (67.4%) than Hispanics (31.6%) (=<0.001). The Hispanic population had a significantly higher proportion of head and neck tumours ( = 0.0004) but a lower proportion of extremity tumours ( = 0.001) compared to NHW. Pigmented BCC was significantly more common among Hispanic patients ( < 0.01). Finally, within the Hispanic group, there was a significant association between sex and histology ( = 0.004), with Hispanic men demonstrating more aggressive mix histology compared to Hispanic women.
Our study supports the notion that BCC disparities occur among POC compared to NHW. This includes variations in epidemiologic factors such as sex and past medical history, primary tumour location, and pathologic characteristics. Further research should be conducted to identify additional differences in skin cancer presentation in POC to reduce the gaps in skin cancer knowledge and care.
基底细胞癌（BCC）是美国最常见的恶性肿瘤。大多数病例在非西班牙裔白人（NHW）中被发现，而在有色人种（POC）患者中则较少见。然而，西班牙裔人口在美国人口中所占比例很大且不断增长，西班牙裔人群中皮肤癌的诊断率也在上升。因此，本研究的目的是探讨西班牙裔与非西班牙裔白人BCC之间的临床病理差异。
对2018年1月至2020年3月在洛杉矶县+南加州大学医学中心确诊为BCC的西班牙裔和非西班牙裔白人患者进行回顾性病历审查。总共纳入了101例来自前100名确定为西班牙裔血统患者的BCC样本，以及50例来自前50名确定为非西班牙裔白人患者的BCC样本进行分析。收集患者特征（年龄、性别、病史和种族）以及肿瘤特征（位置、亚型、肿瘤深度和神经周围侵犯）。我们对连续变量使用组间检验，对分类变量使用卡方检验。
总共在122名受试者（79名西班牙裔和43名非西班牙裔白人患者）中收集了151份标本。在非西班牙裔白人中，大多数患者（74.4%）为男性，但在西班牙裔人群中，大多数（68.4%）为女性（P<0.001）。非西班牙裔白人中其他皮肤癌的既往史（67.4%）比西班牙裔（31.6%）更常见（P<=0.001）。与非西班牙裔白人相比，西班牙裔人群中头颈部肿瘤的比例显著更高（P = 0.0004），但四肢肿瘤的比例更低（P = 0.001）。色素沉着性BCC在西班牙裔患者中明显更常见（P<0.01）。最后，在西班牙裔组中，性别与组织学之间存在显著关联（P = 0.004），与西班牙裔女性相比，西班牙裔男性表现出更具侵袭性的混合组织学。
我们的研究支持这样一种观点，即与非西班牙裔白人相比，有色人种中存在BCC差异。这包括流行病学因素的差异，如性别和既往病史、原发肿瘤位置以及病理特征。应进行进一步研究，以确定有色人种皮肤癌表现的其他差异，以缩小皮肤癌知识和护理方面的差距。
