| Objective: To analyze the histopathological and clinical features of patients with cutaneous basal cell carcinoma(BCC),and to explore the correlation between them.Methods:Collect the first affiliated hospital of guangxi medical university in January 2016 to March 2021 menstrual dermatologist treated by histopathologic diagnosis of 123 cases of basal cell carcinoma in patients with clinical data and pathological data,through the prognosis of patients with follow-up of understanding,the clinical and pathological characteristics by using the methods of single factor analysis,correlation analysis,generalize the conclusion.Results: Among 123 patients with basal cell carcinoma,there were 54males(43.9%)and 69 females(56.1%),with a male-to-female ratio of0.78:1.The age range ranged from 28 to 103 years old(mean age 62.11±14.09 years old),only 7 cases(6.0%)were younger than 40 years old,and people aged60-69 accounted for the highest proportion(28.4%).Follow-up period ranged from half a month to 70 years,with a median course of 3 years.Among the 123 patients,5 cases were multiple basal cell carcinoma(129 lesions),most of which were distributed in the head,face and neck,accounting for 85.4%,including79.2% in the head and face,and 7 in the limbs(5.0%),3 in the vulva(2.5%),and 2 in the trunk(1.6%).The main clinical manifestations of BCC are dark brown nodules and plaques,most of which have clear boundaries with the surrounding lesions.Among all pathological subtypes,nodular type accounted for the highest proportion,with 78 cases(63.4%)of nodular type,27 cases(30.0%)of infiltrative type,and only 6.6% of superficial and adenoid type.For nodular and infiltrative type,most lesions were located in the head and face,while superficial type was more common in the trunk.There was no significant difference in gender,age,course of disease and site composition among all pathological types.Based on the Breslow thickness of melanocytoma,the depth of basal cell carcinoma lesion invasion was measured under the microscope,ranging from 0.5-11 mm.The calculation method was based on the depth of lesion invasion ÷ course of disease = rate of lesion progression,and the median rate of lesion progression was 0.670mm/ year.The infiltration rate of BCC in men was faster than that in women(0.715mm/ year > 0.550mm/ year),those≥62 years old were faster than those under 62 years old(0.775mm/ year >0.500mm/ year),and those with disease course < 3 years were faster than those with disease course ≥3 years(21.880mm/ year > 0.170mm/ year).The differences between the above results were statistically significant.Among the123 patients,113 cases were treated by surgery,of which 47 cases were treated by MOHS surgery,10 cases underwent biopsy only,10 cases were lost to follow-up,7 cases had postoperative recurrence(5.69%),the rest 96 cases did not have postoperative recurrence,the lesions of the recurrent patients were all located in facial H area,and 5 cases had total resection without extensive resection(71.43%).The highly invasive BCC accounted for 42.86%.The pathological classification of 3 cases was consistent before and after recurrence(infiltrative type),1 case showed pathological changes(micronodular type changed to infiltrative type),and 1 case showed basal cell squamous differentiation changes.Conclusion: 1.Gender,age and course of disease are related factors to the infiltration rate of BCC,but they are affected by other factors.2.Surgery is the main treatment method for BCC,which has the advantages of low recurrence rate and good prognosis.The recurrence rate in this study was 5.69%,and the risk factors for recurrence were related to the lesion site,high-risk pathological type and surgical margin diameter.3.The pathological types of basal cell carcinoma before and after recurrence may be the same,or may change,and some of them may differentiate in a more aggressive direction. |
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