121例基底细胞癌手术后随访6年分析  

Analysis of 121 cases of basal cell carcinoma followed up for 6 years

作　　者：刘杏 冯广东 徐聪聪 张倩 王熠昕 陈浩 赵亮 王强 方方 王焱 LIU Xing;FENG Guangdong;XU Congcong;ZHANG Qian;WANG Yixin;CHEN Hao;ZHAO Liang;WANG Qiang;FANG Fang;WANG Yan(Department of Dermatological Surgery,Hospital for Skin Diseases,Institute of Dermatology,Chinese Academy of Medical Science,Peking Union Medical College,Nanjing 210042,China;Department of Dermatology,Wuxi Second People's Hospital,Wuxi 214001,China;Department of Pathology,Hospital for Skin Diseases,Institute of Dermatology,Chinese Academy of Medical Science,Peking Union Medical College,Nanjing 210042,China)

机构地区：[1]中国医学科学院北京协和医学院皮肤病医院皮肤外科,江苏南京210042 [2]无锡市第二人民医院皮肤科,江苏无锡214001 [3]中国医学科学院北京协和医学院皮肤病医院病理科,江苏南京210042

出　　处：《中国麻风皮肤病杂志》2023年第6期409-412,共4页China Journal of Leprosy and Skin Diseases

基　　金：国家重点研发计划(编号:2022YFC2504700)。

摘　　要：目的:比较Mohs显微描记外科手术(Mohs micrographic surgery, MMS)和局部扩大切除术(wide local excision, WLE)对基底细胞癌(basal cell carcinoma, BCC)疗效有无差异,探讨影响BCC手术疗效的因素。方法:统计2013年11月至2015年11月我院皮肤外科病房BCC住院患者信息,并使用SPSS 23.0软件进行统计学分析。结果:BCC患者共121例,肿瘤主要发生在头面部。在切除范围上,WLE组明显大于MMS组[(6.3±2.9)mm vs (4.5±2.2)mm],MMS组肿瘤切净率高于WLE组(100.0%vs 88.7%,P<0.05)。在MMS少量未切净肿瘤扩切2mm后,MMS与WLE的肿瘤切净率无统计学差异(P=0.584>0.05)。WLE切缘4~5 mm时对于BCC的疗效与MMS相当。结论:MMS较WLE有更高的肿瘤切净率和较低的复发率,当MMS实施受限时,推荐4~5 mm手术切缘。Objective:To compare the efficacy of Mohs micrographic surgery(MMS)and wide local excision(WLE)for basal cell carcinoma(BCC)and to explore the factors affecting the efficacy of BCC.Methods:The data of hospitalized patients with BCC in the dermatosurgery ward of our hospital from November 2013 to November 2015 was statistically analyzed using SPSS 23.0 software.Results:A total of 121 patients with BCC were collected,and the tumors were mainly located on the head and face.In the extent of resection,the WLE group was significantly larger than the MMS group(6.3±2.9 mm vs 4.5±2.2 mm),and the tumor resection rate was higher in the MMS group than in the WLE group(100.0%vs 88.7%,P<0.05).There was no significant difference of resection rate between MMS and WLE after a small amount of unresected tumors in MMS were expanded by 2 mm(P=0.584).The efficacy of WLE was equivalent to MMS when resection margin was 4~5 mm.Conclusion:MMS has a higher tumor resection rate and a lower recurrence rate than WLE.When the implementation of MMS is limited,4~5 mm surgical margin is recommended.

关 键 词：基底细胞癌 Mohs显微外科手术 肿瘤复发 

分 类 号：R739.5[医药卫生—肿瘤]