Application Of High Frequency Ultrasound Combined With Dermoscopy In Preoperative Evaluation Of Commom Skin Malignancies

Objective: To investigate the clinical value of high frequency ultrasound combined with dermoscopy in the accurate preoperative evaluation of slow Mohs micrographic surgery(sMMS)for basal cell carcinoma(BCC)and cutaneous squamous cell carcinoma(cSCC).To evaluate the value of high frequency ultrasound combined with dermoscopy in the preoperative evaluation of BCC and cSCC.Methods: A total of 133 cases of BCC and49 cases of cSCC were diagnosed in the Department of Dermatology of Xinjiang Medical University from November 2018 to November 2021,and divided them into the observation group and the control group.The observation group underwent high-frequency ultrasound and dermoscopy before operation to determine the operation boundary of BCC and cSCC,then underwent sMMS.The control group was resected with sMMS.Compared the difference of the number of final surgical resection between the two groups.BCC divided the lesions into high-risk type and low-risk type according to the pathological type,and cSCC divided the lesions into well differentiated cSCC,moderate differentiated cSCC and low differentiation cSCC according to the degree of pathological differentiation.Compare the ultrasonic and dermoscopic features between BCC and cSCC groups.Result: 1.Binary logistic regression analysis showed that high-risk BCC and BCC located in the trunk were the risk factors for multiple operations with whether it was multiple operations as the dependent variable(0 = single operation,1 = multiple operations),gender,age,age of onset,course of disease,tumor length,tumor width,tumor classification or tumor differentiation as the independent variables.2.There was no significant difference in the number of final surgical resection between BCC,cSCC observation group and control group(BCC: P=0.989,cSCC: P=0.569).3.There was significant difference in posterior acoustic shadow between BCC in high-risk group and BCC in low-risk group(P=0.003);There was no significant difference between well differentiated cSCC and moderate differentiated cSCC(P>0.05);There was significant difference in the characteristics of branching vessels in dermoscopy between BCC in high-risk group and BCC in low-risk group(P=0.037);There was no significant difference in dermoscopic characteristics between well differentiated cSCC and moderate differentiated cSCC(P>0.05).Conclusion: Although our final results did not confirm that high-frequency ultrasound combined with dermoscopy can reduce the number of final surgical resection of sMMS,it can evaluate the risk of BCC and cSCC lesions before operation and preliminarily determine the surgical edge,so as to guide the formulation of surgical plan,reduce the number of surgical operations and reduce the recurrence rate of tumor as much as possible.