| Objective:Basal cell carcinoma(BCC)is a low-grade malignant tumor originating from basal cells.It is common in clinics and occurs mostly in the elderly.BCC usually has insidious onset,with diverse clinical manifestations,high clinical misdiagnosis rate and great local destruction,so the disease has attracted more and more attention.With the development of molecular biology,the research of BCC has reached at molecular level.Some studies have shown that external factors such as ultraviolet rays etc.may cause indirect damage to DNA,which contributes to the DNA mutation and misexpression,thereby trigger carcinogenesis.In order to increase the awareness of plastic surgery clinicians on BCC,reduce the rate of clinical misdiagnosis and avoid unnecessary clinical examinations,this study conducted a comprehensive analysis of clinical medical records,surgical treatment methods and postoperative follow-up of patients with BCC in our hospital,which provides theoretical support for surgeons to diagnose and treat the disease.Method:The clinical data of 170 BCC patients admitted in the First Affiliated Hospital of Zhengzhou University from January 2014 to January 2019 has been collected.All patients were treated by the department of plastic surgery and diagnosed by the department of pathology.The clinical data of patients’ gender,age,course of disease,distribution area,clinical manifestations(length,color,shape,boundary,ulceration,texture and tenderness),pathological types,clinical and pathological diagnosis coincidence rate,surgical treatment and prognosis were analyzed retrospectively.The corresponding statistical software was used for statistical analysis and clinical conclusions were drawn.Result:(1)Epidemiology:Among 170 patients enrolled,67 cases(39.4%)were males,102 cases(60.6%)were females,the ratio of male to female ratio was 0.65:1.The age diagnosed as BCC ranged from 30 years old to 104 years old(mid age 62 years old).The course of disease ranged from 1 month to 70 years,with a mid duration of 8 years.The diameter of the lesions ranged from 0.2 cm to 7 cm,with an average diameter of 1.62 cm.Head and face were the most common places where had 167 lesions(90.8%),followed by 10 lesions(5.4%)in the trunk,6 lesions(2.7%)in the limbs and 1 lesion(0.5%)in the sacrococcygeal.No lesions in the genital area were observed.(2)Preoperative diagnosis and surgical treatment:170 patients had 184 lesions.The number of lesions diagnosed as BCC before surgery was 109,with a coincidence rate of 59.24%.All lesions were treated with surgery,72 lesions(39.1%)were sutured directly after resection.There were 31 lesions(16.9%)who underwent local flap transfer and 81 patients(44.0%)who underwent skin graft after surgical resection.(3)Clinical Pathology:112 lesions were nodular subtype(60.87%),3 were micronodular(1.63%),13 were superficial(7.07%),38 were pigmented(20.65%),1 was sclerosing(0.54%),13 were basosquamous(7.07%)and 5 were adenoid(2.71%).(4)Prognosis and follow-up:After surgery,160 cases out of 170 patients healed in stage I.The patients were followed up by the telephone or outpatient department after surgery with a interval from 6 months to a year,3 cases had recurrence after surgery,165 cases did not relapse and 2 cases were lost contact.The operative areas recovered well,only 15 cases had hypertrophy.Conclusions:(1)BCC usually occurs in people over 40 years old,the ratio of man to woman was 0.65:1.it usually occurs in head and face,single lesion is more common,and it is highly related to ultraviolet exposure.(2)Nodular was the main histopathological type,followed by pigmented and superficial.The preoperative diagnosis coincidence rate was 59.24%,which was confused with nevus,squamous cell carcinoma,chronic ulcer and seborrheic keratosis etc.(3)Surgery is the main treatment method for basal cell carcinoma.There are three types of surgery methods to choose,suturing directly after resection,flap transferring and skin grafting,the postoperative recurrence rate is low. |
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