| Background: Basal Cell Carcinoma (BCC) is the most common skin cancers in the white skin population. Recent studies showed the wide variation of histological subtypes in the classification of BCC around the world. Histological subtypes may imply a different clinical behavior and in recent study also been considered to have different etiology. The differences of clinical behaviors could lead to a low rate of clinical diagnosis accuracy of BCC in a country where the incidence rate of BCC relatively low.Objectives: The aim of this study is to analyze the characteristic of BCC clinically and the clinical diagnosis accuracy for BCC at a hospital-based retrospective study for period 7 years.Methods: All biopsied patients who histopathologically confirmed as BCC and/or all patients who clinically diagnosed as BCC at Dermatology and Venereology Department of First Affiliated Hospital of Chong Qing University of Medical Science from January, 2001 to December, 2007 were included in the study. A retrospective analysis was performed on 83 cases histopathologically confirmed BCC. Result were analyze with SAS 8.2 statistics software by using Pearson Chi-Square Test and Cochran-Armitage Trend Test for hypothesis testing. Result were considered to be statistically significant for p value <0.05.Results: From 83 cases histopathology confirmed as BCC, male: female ratio was 1:0.93. The mean age was 61.72 years (SD±12.99). The youngest age was 21 years, the oldest was 89 years. The highest numbers of BCC were seen in seventh decade age groups which occupied 26.51%. According to histological subtype, 65.06% were nodular, 12.95% superficial, 10.84% pigmented, 8.43% fibroepithelioma of Pinkus (FEP) and 3.61% morpheaform. Except for superficial type which mostly occurred on trunk (66.67%), others type of BCC predominantly occurred on the head and neck region (90.74% of nodular, 60% of pigmented, 100% of morpheaform, 85.71% of FEP). Nodular and morpheaform type were mostly biopsied between 1-5 years since the lesion first emerged (58.7% and 66.67%). While superficial type was mostly biopsied after the time longer than 5 years (62.5%). Pigmented and FEP subtype were biopsied equally shorter than 5 years and longer than 5 years (50%). According to location, lesions occurred on the head and neck region mostly biopsied after 1-5 years (63.64%), whereas lesions on trunk and extremities were longer than 5 years (84.61% and 100%). Most of the nodular, morpheaform and FEP tumor size were smaller than 1cm2 (66.67%, 100% and 66.67%), whereas superficial and pigmented type were larger than 1cm2 (85.71 and 75%). According to location, 64% of the tumor occurred on the head and all tumors on extremities were smaller than 1cm2, whereas 88.89% tumor occurred on the trunk were larger than 1cm2. The sensitivity of clinical diagnoses of BCC in our department was 44.58% and the positive predictive value (PPV) was 71.15%.Conclusion: This study shown the characteristic of BCC according to histological subtype, anatomical distribution, tumor size and patient age when the tumor emerged, which have many similarity to previous studies conducted in China or other country. Clinical behaviors of BCC were varies according to its histological subtype. Especially for the superficial type, which has shown a significant differences in many variable such as predilection site, tumor size, age of emerged and its growing nature. Study focused on superficial BCC should be carried to get more information about characteristic of this type. |
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