J Dermatolog Treat:皮肤镜指导下的莫氏显微手术治疗激光后残留基底细胞癌:皮肤镜对手术边缘的划分有帮助吗?

2022-04-08 MedSci原创 MedSci原创

莫氏显微手术(MMS)是治疗基底细胞癌(BCC)的常用技术。在肉眼对肿瘤边缘界定不清的情况下,MMS可能导致需要采取更多的莫氏分期。

莫氏显微手术(MMS)是治疗基底细胞癌(BCC)的常用技术。在肉眼对肿瘤边缘界定不清的情况下,MMS可能导致需要采取更多的莫氏分期。皮肤镜是一种无创技术,能够在体内观察到肉眼不易发现的表皮和真皮浅层的结构。近日,发表于J Dermatolog Treat的一项随机研究首次调查了皮肤镜是否有助于界定MMS的手术边缘,特别是对于通常具有不清晰边缘的激光后BCCs病例。通过分别调查第一个MMS阶段的侧面和深层边缘受累率,试图提高对皮肤镜在激光后BCC的MMS中的作用的理解。

研究人员按手术边缘检测方法将患者随机分配到裸眼组(n = 69)或皮肤镜组(n = 64)。然后分析了133名用MMS治疗的激光后BCC患者的手术结果。

结果显示,皮肤镜组在第一个MMS阶段的侧缘受累率明显低于裸眼组(4.7% vs. 29.0%;P < .001)。然而,第一和平均MMS阶段的深层边缘受累率在各组之间没有显著差异。这些数据意味着MMS阶段的数量可能主要取决于深缘受累情况。分析与激光治疗后BCCs的MMS期数有关的因素结果显示,仅有消融性激光治疗时间是与MMS期数相关的因素(p = .026)。

综上所述,该研究结果表明,通过皮肤镜检查,侧缘大多控制在第一个MMS阶段内。皮肤外科医生可以在第一个MMS阶段后关注深层边缘;因此,在皮肤镜的帮助下,可以提高激光治疗后BCC患者的MMS效果。

原始出处:

Kihyuk Shin, et al.,  Dermoscopy-guided Mohs micrographic surgery in post-laser basal cell carcinomas: is dermoscopy helpful for demarcation of the surgical margin? J Dermatolog Treat. 2022 Feb;33(1):433-436. doi: 10.1080/09546634.2020.1762839. 

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    2022-04-09 oliver169
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