皮肤基底细胞癌 (stroma) 的组织学边缘参与:对残留或复发性癌症的回顾性队列研究
Danielle R Rinck1, Steven R Tahan2
1Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Journal of clinical pathology
|January 23, 2026
概括
基底细胞癌 (BCC) 中的流体边缘参与很少导致复发,特别是在非表面亚型中. 管理可以更有选择性,避免在没有表面组件的情况下对BCC进行例行重新切割.
科学领域:
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 基底细胞癌 (BCC) 相关的肌瘤对组织学边缘的影响具有不确定的临床意义.
- 了解残留疾病风险对于优化BCC管理策略至关重要.
研究的目的:
- 为了确定在再切割标本中的残留BCC的发生率.
- 评估在不进行再切割的情况下管理的BCC病例中的临床复发率,当涉及筋膜边缘时.
主要方法:
- 追溯审查58个BCC病例,其中包括 stromal边缘 (2016-2020年).
- 分析了50例接受立即再切割的病例和8例在临床观察下管理的病例.
- 按BCC组织学亚型和树叶边缘参与 (外围,深层或两者兼而有之) 进行分类.
主要成果:
- 在8%的重新切除病例中 (4/50),仅在具有表面成分的瘤中发现了残留性癌症.
- 在经过再切割的结节性或透性BCC中没有观察到残留癌症.
- 总体残留或复发性疾病发生在7%的病例中 (4/58),结果因组织学亚型而异.
结论:
- 在非表面的BCC中,流体边缘参与具有较低的残留或复发疾病风险.
- 不良结果仅限于具有表面成分的BCC,表明亚型特定的生物学.
- 对于缺少表面成分的 stromal-margin-positive BCCs,可能不需要进行常规的重新切割,以支持亚型知情管理.
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