机构地区:[1]新疆医科大学第一附属医院整形外科,新疆乌鲁木齐830000
出 处:《中国美容整形外科杂志》2022年第12期725-728,共4页Chinese Journal of Aesthetic and Plastic Surgery
摘 要:目的探讨皮肤基底细胞癌的高危因素及与毛母细胞瘤的病理特征差异性及鉴别诊断方法。方法选取2018年1月至2021年1月,新疆医科大学第一附属医院整形外科就诊的35例毛母细胞瘤和118例皮肤基底细胞癌患者,同期随机抽取60例健康志愿者,对所有受试者进行问卷调查,调查内容包括一般情况(性别和年龄等)、家族疾病史、药物使用史、生活习惯、职业、皮肤光敏分型等方面。手术切除取所有患者肿瘤组织标本进行HE染色检查,免疫组化检查B淋巴细胞瘤-2基因(Bcl-2)、雄激素受体(AR)、CD10表达情况。采用Logistics回归分析高危因素。结果单因素分析结果显示,毛母细胞瘤患者与健康志愿者在家族遗传史、长期暴晒有无保护措施、是否受过辐射、是否接受过免疫抑制剂治疗、皮肤光敏分型、职业、户外暴晒时间方面比较,差异具有统计学意义(P<0.05);Logistic多元回归分析结果显示,存在家族遗传史、长期暴晒无保护措施、受过辐射、接受过免疫抑制剂治疗、皮肤光敏类型为Ⅲ和Ⅳ型者、室外工作、户外暴晒时间>4 h为皮肤基底细胞癌发生的高危因素(P<0.05);两种肿瘤患者的Bcl-2、AR、CD10表达情况比较,差异具有统计学意义(P<0.05)。结论皮肤基底细胞癌的高危因素很多,家族遗传史、辐射、免疫抑制剂治疗、皮肤光敏类型为Ⅲ和Ⅳ型者、室外工作、户外暴晒时间>4 h均为其高危因素,皮肤基底细胞癌与毛母细胞瘤的病理特征差异性较低,诊断时易发生混淆,建议结合临床高危因素、病理组织学检查和免疫组化检查结果综合进行诊断,以提高鉴别诊断的准确性。Objective To explore the high risk factors of skin basal cell carcinoma,the differences in pathological characteristics and differential diagnosis between skin basal cell carcinoma and trichoblastoma.Methods A total of 35 patients with trichoblastoma and118 patients with skin basal cell carcinoma from January 2018 to January 2021 were selected.At the same period,60 healthy volunteers were randomly selected and questionnaire survey was performed in all volunteers.The content of questionnaire survey includes general conditions(such as gender and age),family history of disease,history of drug use,living habits,occupation and skin photosensitivity classification.The samples of tumor were collected from all patients after surgical resection for HE staining,and immunohistochemistry was used to examine the expression of B-lymphoma-2 gene(Bcl-2),androgen receptor(AR)and CD10.The logistic regression was used to analyze high-risk factors.Results Univariate analysis showed that there was statistical significance in family history,long-term sun exposure,radiation,immunosuppressive therapy,skin photosensitivity classification,occupation and outdoor exposure between patients with trichoblastoma and healthy volunteers(P<0.05).Multiple logistic regression analysis showed that the family history,long-term exposure without protection,radiation,immunosuppressive therapy,skin photosensitivity typeⅢandⅣ,outdoor work and outdoor exposure more than 4 hours were high risk factors of skin basal cell carcinoma(P<0.05).There were significant differences in the expression of Bcl-2,AR and CD10between skin basal cell carcinoma and trichoblastoma(P<0.05).Conclusion There are many high risk factors for skin basal cell carcinoma,including family history,radiation,immunosuppressive therapy,skin photosensitivity typeⅢandⅣ,outdoor work and outdoor exposure more than 4 hours.The difference in pathological characteristics between skin basal cell carcinoma and trichoblastoma was low.It is easy to be confused in diagnosis.It is recommended to c
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