中国皮肤基底细胞癌诊疗指南(2023版)  

Chinese guildeline on diagnosis and treatment of basal cell carcinoma(2023 edition)

作　　者：国家皮肤与免疫疾病临床医学研究中心 中国医师协会皮肤科分会 李航[2] 王焱 万苗坚[4] 吴文育 冉梦龙[2] 闫钇岑 National Clinical Research Center for Skin and Immune Diseases;Chinese Medical Doctor Association of Dermatology;Li Hang;Wang Yan;Wan Miaojian;Wu Wenyu(不详;National Clinical Research Center for Skin and Immune Diseases/Department of Dermatology and Venereology,Peking University First Hospital,Beijing 100034,China;Department of Dermatologic Surgery,Hospital(Institute)of Dermatology,Nanjing 210042,China;Department of Dermatology and Venereology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Dermatology,Shanghai Huashan Hospital,Shanghai 200040,China)

机构地区：[1]不详 [2]国家皮肤与免疫疾病临床医学研究中心,北京大学第一医院皮肤性病科,北京100034 [3]中国医学科学院皮肤病医院(研究所)皮肤外科,南京210042 [4]中山大学第三附属医院皮肤性病科,广州510630 [5]上海华山医院皮肤科,上海200040

出　　处：《中华医学杂志》2024年第6期391-410,共20页National Medical Journal of China

基　　金：国家重点研发计划(2022YFC2504700、2022YFC2504701)

摘　　要：皮肤基底细胞癌(BCC)是最常见的皮肤恶性肿瘤之一,高加索人群患病率高于东亚人群。虽然我国缺少流行病学数据,但由于人口老龄化日益显著,普遍认为中国BCC发病率有上升趋势。BCC发生的危险因素众多,其中紫外线和基因突变起主要作用,尤其是Hedgehog(Hh)信号通路的异常激活,被认为是BCC最重要的发病机制。BCC的临床表现具有较强的特征性,大部分有临床经验的医生可通过临床表现初步诊断,借助皮肤镜等影像学手段可以极大提升诊断的准确率,但仍有部分不典型或罕见类型的BCC需要进一步通过组织病理学确诊。本指南由国家皮肤与免疫疾病临床医学研究中心(依托北京大学第一医院)发起,邀请中国医师协会皮肤科分会皮肤外科学组以及皮肤肿瘤学组、中国中西医结合学会皮肤性病专业委员会皮外科学组、中国麻风协会皮肤外科与美容分会24名资深皮肤外科专家为主体,同时邀请烧伤整形(颌面)外科、眼科、耳鼻咽喉头颈外科、放射治疗科以及病理科专家参与,成立了《中国皮肤基底细胞癌诊疗指南(2023版)》指南专家组,根据国内外最新的研究成果,通过专家组四轮讨论修订后形成指南,为临床医护人员诊治BCC提供有价值的参考。Basal cell carcinoma(BCC)is the most common skin malignancy,with a higher prevalence in Caucasians than in East Asians.Although there is a lack of epidemiological data in China,it is generally believed that the incidence of BCC in China is increasing due to the aging population.A variety of risk factors are related to the occurrence of BCC,among which ultraviolet rays and gene mutations play a major role,especially the abnormal activation of Hedgehog(Hh)signaling pathway,which is considered to be the most important pathogenesis of BCC.The clinical manifestations of BCC are highly specific,and most experienced doctors can make a preliminary diagnosis by clinical manifestations.Dermoscopy and other imaging methods can greatly improve the accuracy of diagnosis,but there are still some atypical or rare types of BCC that need further confirmation through histopathological examination.This guideline is initiated by the National Clinical Research Center for Skin and Immune Diseases(based on Peking University First Hospital).It has invited a panel of experts consisting of 24 senior dermatologists specializing in dermatologic surgery from the Dermatologic Surgery Group of the Chinese Medical Doctor Association of Dermatology,the Dermatologic Surgery Group of the Dermatology&Venereology Committee,Chinese Association of Integration Medicine,and the Dermatologic Surgery and Cosmetic Branch of Clina Leprosy Association.In addition,experts from the Burn and Plastic Surgery(Maxillofacial),Ophthalmology,Otolaryngology,Head and Neck Surgery,Radiation Therapy,and Pathology were also invited to participate.This panel forms the"Chinese Guideline for the Diagnosis and Treatment of Basal Cell Carcinoma"expert group.Based on the latest domestic and international research findings,the guideline was developed through four rounds of discussions by the expert group and revised to provide valuable references for clinical healthcare providers in the diagnosis and treatment of BCC.

关 键 词：癌 基底细胞 诊断 手术治疗 药物治疗 物理治疗 随访 指南 

分 类 号：R739.5[医药卫生—肿瘤]