Clinic And Pathology Contrast Analysis Of 72 Patients With Basal Cell Carcinoma

Basal cell carcinoma is one of the most frequent malignant skintumor, the main occurr in the first face, especially nose, eyelid andbuccal division. It has the highest incidence in the elderly. It hasupward trend of the world in recent years. The United States andother white-dominated areas have higher incidence. The morbidity ofBCC less than SCC in our country, but statistics show a rising trendin recent years. It's etiological factors and etiopathogenisis are complicated.BCC is that the incidence may be related to ultraviolet, cancer genemutations, human papilloma virus infections, arsenical and geneticfactors. The environmental factor has played an important role information process of BCC, that the solar chronic repeated exposuremight be the main reason in formation progress of BCC. And theincidences are differences in different ethnic, different regions,different nature of work and different age. UV excessive exposureinduce to BCC not only damaged DNA of epidermic Malpighian cell,to interfere with synthesis and repair of normal DNA lead to thegenic mutation, but also caused the disorder of apoptosis that resultin destructing stability of dermatic internal environment. Themalignant degrees and metastatic rates are more lower than othermalignant tumors, but the malignant degree constantly increasingwith recurrence and augmentation of tumor, and leading tometastasis eventually. The aggressiveness and destructivenessobviously increasing after recurrence or augmentation of tumor, itcan destruct the texture and the structure to lead to functionalobstacles of organ, and then even death of serious patients. Therefore,early diagnosis and early treatment is the key to controlling thedevelopment of BCC. Early diagnosis not only depends on theunderstanding of disease of patients, but also depends on the degreeof attention of doctors. The clinical types of BCC are variegated andatypism of skin lesion, resulting in high rates of clinical misdiagnosis.The different clinical types need to indentify with different clinicaldiseases, and histopathologic diagnosis with high diagnostic rate.Meanwhile the classification of histopathologic subtypes conduciveto judging the clinical prognosis and choosing appropriate treatments.The treatments of BCC are varied, many new treatments which canenhance cosmetology and reduce recurrence rate had extensiveclinical application, such as immunomodulator, gene therapy andother new therapies increasingly been highlighted in research fields.To increase public awareness of the disease by health education andreduce solar exposure to prevention, early discovery and earlytreatment can reduce the incidence of disease and mortality.Because of low mortality rate, it has not been sufficientattention by the public and clinician, but it has induce remarkablehazard of public health. To improve the standards of diagnosis,precaution and treatment for reducing the incidence of disease andmortality, a retrospective review had been conducted from 1987 to2005, 72 cases with exlicit pathologic diagnosis of dept. ofdermatology in our hospital are analysed. A integrated analysis aboutthe clinical, pathology, diagnostic characteristics, its causes,prevention and treatment have been done. According to the clinicalcriteria divided into noduloulcerative type, pigmented type,morphealike or fibrosing type and superficial type. According totheir main category of pathological types they are: entity type,superficial type, adenoid type, pigmented type, sclerosing type,keratotic type and cystic type. In accordance with Sexton andMaloney's criteria for the classification of BCC, pathologicalsubtypes are divided into six types: nodular type, superficial type,micronodular type, infiltrative type, morpheic type, mixed type.They are divided into non-invasive group and invasive group. 40cases are male, 32 cases are female of 72 patients, the proportion ofmen and women to 1.25:1. Age of onset from 34 years to 87 yearsold, with an average of 59.61±12.50 years. 57 (79.17%) cases are50 and above 50 years of age, 15 (20.83%) persons whose age under50 years. Course of disease from four months to 40 years, with anaverage of 4.49±6.43 years. There are 41 cases of peasants, 16cases of workers and 15 cases of other occupations. Incidence parts:there are 63 cases take place on first face, one cases on neck, fourcases on trunk and the limbs of four cases. The largest area of skinlesion is 13cm x 15cm, the smallest diameter is 0.2cm of 72 cases.68 (94.44%) cases of tumors are single, 48 (66.67%) cases take placeulcers with the tumor, and 70 cases (97.22%) are clear lines of 72cases. The most common clinical types are pigmented type andnoduloulcerative type, respectively 35 cases (48.61%) and 24 cases(33.33%). Pathological type entity with 33 cases (45.83%) up to see,followed by adenoid with 17 cases (23.61%). Pathological subtypeclassification: the largest is 29 nodular cases (40.28%), followed by13 infiltrative cases (18.06%), 9 cases of nodrlar-micronodular(12.50%) are the most common in the mixed type. There are 33 casesof non-aggression groups and 39 cases against group. The clinicaldiagnosis rate is 69.44%, and clinical misdiagnosis rate of 30.56%.χ2-test for statistical processing.The results of the study are:1. 72 cases of BCC patients, there are no significant differencebetween age of onset and male-female constitute ratio (P>0.05), 50years and older patients are particularly prevalent.2. The first face is the most common which occur in exposedparts, and the differences are very significant about different agesand different occupations, among 72 cases with BCC, 50 years andolders are more common (P<0.01);farmers and workers are up tosee (P<0.01).3. The tumors which take place ulcer in the central betweenmen and women (P<0.05) and about different age (P<0.05) havesignificant differences.4. There are no significant differences between incidence of agemale-female constitute ratio in different pathological types (P>0.05);superficial type more occur in trunk of various types (P<0.01), therest type is known in the first face (P<0.01).5. The clinical types of pigmented type most vulnerable tomisdiagnosis (P<0.05).We can draw some conclusion from our study, as follow:1. Chroniclly long-term solar exposure associated with theoccurrence of BCC.2. Subdivisions of histopathology and histopathologicalsubtypes are crucial about diagnosis, treatment and judgment ofprognosis of BCC.3. To understand the invasive and destructive of BCC impact tothe human health for improving the degree of reconstruction ofclinician.4. Timely and reasonable treatment is important factor to reducethe recurrence of BCC.5. Raising public awareness of health education is key to reducemorbidity and mortality of BCC.