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目的:探讨头面部基底细胞癌(BCC)的男女发病差别、发生部位及手术切缘与复发和转移的关系。方法:采用回顾性研究的方法对我院耳鼻咽喉-头颈外科1996~2003年41例头面部BCC患者的临床资料进行分析。结果:男17例,女24例;男女1.00∶1.41,男女发病数差异有统计学意义(P<0.01)。BCC高发年龄为55~74岁,平均发病年龄女性为68.1岁,男性为58.4岁。BCC发生于鼻周13例(31.7%)、头皮8例(19.5%)、眶周7例(17.1%)、唇部7例(17.1%)、面颊部4例(9.8%)以及耳周2例(4.9%)。在手术治疗的患者中,T1期肿瘤切缘为0.3 cm者(20例)与0.5 cm者(11例)两组切缘阳性率比较,差异有统计学意义(P<0.05)。首诊时,有4例已发现局部淋巴结转移或发生局部骨质破坏,占9.8%。平均随访时间1.2年,有3例新发BCC,占7.3%。结论:中老年女性BCC发病高于同龄男性,可能与浙江省人民的生活劳动习惯以及地理环境有关;鼻周、头面部发病与紫外线照射以及局部皮脂腺密度相关。T1期肿瘤的手术安全切缘应达到0.5 cm。
Objective: To investigate the difference between male and female patients with head and facial basal cell carcinoma (BCC), the relationship between site and surgical margins and recurrence and metastasis. Methods: The clinical data of 41 patients with head-and-face BCC from 1996 to 2003 in our department of Otolaryngology-Head and Neck Surgery were retrospectively studied. Results: There were 17 males and 24 females, with a male-female ratio of 1.00:1.41. There was significant difference in the number of male and female patients (P <0.01). BCC high incidence of 55 to 74 years old, the average age of onset of women was 68.1 years, 58.4 years for men. BCC occurred in 13 cases of nasal (31.7%), 8 cases (19.5%) of scalp, 7 cases (17.1%) of periorbital, 7 cases of lip (17.1%), 4 cases of cheek (9.8% Example (4.9%). Among the patients undergoing surgical treatment, the positive rate of the margins of margins at T1 was 0.3 cm (20 cases) and 0.5 cm (11 cases), the difference was statistically significant (P <0.05). The first visit, 4 cases have been found in local lymph node metastasis or local bone destruction, accounting for 9.8%. With a mean follow-up of 1.2 years, there were 3 new cases of BCC, accounting for 7.3%. Conclusion: The incidence of BCC in middle-aged and elderly women is higher than that in men of the same age, which may be related to the living habits and geographical environment of people in Zhejiang Province. The incidence of nasal and head and face is related to ultraviolet radiation and local sebaceous gland density. Surgical margin of T1 tumor should reach 0.5 cm.