Mohs显微描记手术在鼻面部基底细胞癌中的应用  

Application of Mohs microsurgery in nasal basal cell carcinoma

作　　者：马伟元[1] 刘文[3] 李学忠[2] 叶萍[2] 张立强[2] 蔡晓岚[2] Ma Weiyuan;Liu Wen;Li Xuezhong;Ye Ping;Zhang Liqiang;Cai Xiaolan(Department of Dermatology, Qilu Hospital of Shandong University, Jinan 250012, China;Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan 250012, China;Department of Otorhinolaryngology, Northern Region, Central Hospital of Shandong Zibo, Zibo 255031, China)

机构地区：[1]山东大学齐鲁医院皮肤科,济南250012 [2]山东大学齐鲁医院耳鼻咽喉科,济南250012 [3]山东淄博市中心医院北院区耳鼻咽喉科,255031

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第6期440-443,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：山东省重点研发计划（2016GSF201104）

摘　　要：目的 讨论Mohs显微描记手术（Mohs手术）在鼻面部基底细胞癌（basal cellcarcinoma,BCC）中的应用,分析其病理检查方法及手术特点.方法 回顾性分析2010年1月至2015年1月就诊于山东大学齐鲁医院皮肤科及耳鼻咽喉科经病理确诊的127例鼻面部BCC患者的临床资料,总结鼻面部BCC的好发部位、皮损特征、组织病理学表现,探讨Mohs手术的特点.结果 本组BCC患者男女比例1.27：1,年龄27 ～91岁.位列前三的发病部位依次为鼻背、鼻根及上唇;最常见的临床类型为结节溃疡型;最常见的组织病理学类型为结节型和色素型.行常规手术切除62例（48.8％）;Mohs手术38例（29.9％）.术后平均随访37个月,常规手术切除术后5例局部复发（5/62）,Mohs手术后未见复发,所有患者均未发生肿瘤远处转移.结论 鼻面部BCC临床表现缺乏特异性,手术是首选治疗方法.Mohs手术可严格控制切除范围,在彻底切除局部病变的同时,兼顾鼻面部术后修复与美观.Objective To discuss the application of Mohs microsurgery in nasal and facial basal cell carcinoma （BCC） and analyze the pathological and clinical features.Methods The clinical data of 127 patients who were diagnosed by pathology as nasal and facial BCC in Qilu Hospital of Shandong University from January 2010 to January 2015 were retrospectively analysed.The value of Mohs microsurgery was discussed and the nasal ＆ facial sites of BCC lesions,clinical and histopathology features were summarized.Results The proportion of male and female was 1.27：1 in 127 patients,the ages ranged from 27 to 91 years.The top three inflicted area in nasal and facial was followed by nasal dorsum,nasal root and upper lip.The most frequent clinical type was nodular ulcerative type.The most common pathological type was nodular and pigmented.Routine surgical resection was performed in 62 cases （48.8%） while Mohs micrographic surgery in 38 cases （29.9%）.Follow-up duration was 37 months on average.Local recurrence occurred in 5 cases in routine surgical resection group while there was no recurrence in Mohs micrographic surgery group.There was no distant metastasis in all cases.Conclusions There are few specific clinical manifestation in nasal ＆ facial BCC.Surgical treatment is prefered,especially by Mohs micrographic surgery,because it can strictly control the scope of surgical resection and obtain malformation repairment as well as beauty in nasal and facial region.

关 键 词：癌 基底细胞 鼻 面部 Mohs显微描记手术 

分 类 号：R739.6[医药卫生—肿瘤]