皮肤镜联合高频超声在皮肤恶性肿瘤术前的应用价值分析  

Analysis of the Application Value of Dermoscopy Combined with High Frequency Ultrasound in Preoperative Treatment of Skin Malignant Tumor

作　　者：廖丽萍 汪军喜 廖美玲 IAO Liping;WANG Junxi;LIAO Meiling(Department of Dermatology,Shangrao Institute of Dermatology and Venereal Disease Control Hospital,Shangrao 334000,Jiangxi,China)

机构地区：[1]上饶市皮肤病性病防治所皮肤内科,江西上饶334000

出　　处：《医学信息》2025年第9期153-157,共5页Journal of Medical Information

基　　金：上饶市科技计划医疗卫生指导性项目(编号:2023CZDX123)。

摘　　要：目的研究皮肤镜联合高频超声在皮肤恶性肿瘤术前的应用价值。方法以2021年1月-2023年12月上饶市皮肤病性病防治所收治的186例皮肤恶性肿瘤患者为研究对象,其中基底细胞癌(BCC)96例、皮肤鳞状细胞癌(cSCC)90例,经随机数字表法分为对照组(93例)与观察组(93例),对照组行慢莫氏显微描记手术(sMMS)治疗,观察组则应用皮肤镜联合高频超声+sMMS手术治疗,比较两组的手术切除次数、手术时间,分析观察组BCC患者、cSCC患者的皮肤镜与高频超声表现。结果观察组手术切除次数、手术时间少于对照组(P<0.05)。皮肤镜检查显示,观察组低危型BCC患者与高危型BCC患者的分枝状血管占比有统计学差异(P<0.05);观察组高频超声检查显示,低危型BCC患者与高危型BCC患者的后方声影变化有统计学差异(P<0.05)。低分化型cSCC患者与中、高分化型cSCC患者的皮肤镜色素结构检查中白色无结构区域占比有统计学差异(P<0.05);低分化型cSCC患者与中、高分化型cSCC患者高频超声表现无统计学差异(P>0.05)。结论皮肤镜联合高频超声可减少皮肤恶性肿瘤患者的手术切除次数,缩短其手术时间,反映病灶的病理分型,具有良好的术前评估价值。Objective To study the application value of dermatoscopy combined with high frequency ultrasound in preoperative treatment of skin malignant tumors.Methods A total of 186 patients with skin malignant tumors admitted to Shangrao Institute of Dermatology and Venereal Disease Control Hospital from January 2021 to December 2023 were selected as the research objects,including 96 patients with basal cell carcinoma(BCC)and 90 patients with cutaneous squamous cell carcinoma(cSCC).They were divided into control group(93 patients)and observation group(93 patients)by random number table method.The control group was treated with slow Mohs micrographic surgery(sMMS),while the observation group was treated with dermoscopy combined with high frequency ultrasound+sMMS.The number of surgical resections and operation time were compared between the two groups.The dermoscopic and high frequency ultrasound findings of BCC patients and cSCC patients in the observation group were analyzed.Results The number of surgical resection and operation time in the observation group were less than those in the control group(P<0.05).Dermatoscopy showed that there was a statistically significant difference in the proportion of branching vessels between low-risk BCC patients and high-risk BCC patients in the observation group(P<0.05).The high-frequency ultrasound examination in the observation group showed that there was a statistically significant difference in the posterior acoustic shadow changes between the low-risk BCC patients and the high-risk BCC patients(P<0.05).There was a statistically significant difference in the proportion of white unstructured areas in the dermoscopic pigment structure examination between patients with poorly differentiated cSCC and patients with moderately and highly differentiated cSCC(P<0.05).There was no significant difference in high-frequency ultrasound findings between patients with poorly differentiated cSCC and patients with moderately and highly differentiated cSCC(P>0.05).Conclusion Dermoscopy combined with

关 键 词：基底细胞癌 皮肤鳞状细胞癌 慢莫氏显微描记手术 皮肤镜 高频超声 术前诊断 

分 类 号：R739.5[医药卫生—肿瘤]