| 朱阳春,陈文,崔立刚,孙洋,付帅.皮肤基底细胞癌、鳞状细胞癌及脂溢性角化病临床和超声特点[J].中国医学影像技术,2023,39(11):1698~1701 |
| 皮肤基底细胞癌、鳞状细胞癌及脂溢性角化病临床和超声特点 |
| Clinical and sonographic features of skin basal cell carcinoma, squamous cell carcinoma and seborrheic keratosis |
| 投稿时间：2023-03-30 修订日期：2023-07-12 |
| DOI：10.13929/j.issn.1003-3289.2023.11.023 |
| 中文关键词: 皮肤肿瘤 癌,基底细胞 癌,鳞状细胞 角化病,脂溢性 超声检查 |
| 英文关键词:skin neoplasms carcinoma, basal cell carcinoma, squamous cell keratosis, seborrheic ultrasonography |
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| 中文摘要: |
| 目的 观察皮肤基底细胞癌(BCC)、鳞状细胞癌(SCC)及脂溢性角化病(SK)的临床和超声特征。方法 回顾性分析68例BCC(69处病变)、44例SCC(44处病变)和27例SK(28处病变)患者资料,观察其临床及超声特征。结果 BCC组及SCC组位于曝光部位病变占比高于SK组(P均＜0.017)。3组病变最大径、累及深度、累及皮肤层次、病变形态、多发点状高回声、病变基底部边界、后方回声、血流信号及淋巴结转移差异均有统计学意义(P均＜0.05);SCC组病变最大径和累及深度均大于BCC组和SK组(P均＜0.017);SK组形态规则病变占比大于SCC组(P＜0.017);仅BCC组病变表现为多发点状高回声(P均＜0.017);SCC组淋巴结转移发生率高于BCC组(P＜0.017);SK组病变多仅累及表皮,且基底部边界多清晰,而BCC组和SCC组病变多浸润至真皮层或皮下组织(P均＜0.017),且与BCC组相比,SCC组更易侵犯皮下组织(P＜0.017);SK组病变多无血流信号或仅有少量血流信号,而BCC组多为中等血流信号、SCC组多为丰富血流信号(P均＜0.017)。结论 皮肤SK可发生于全身多部位,仅累及皮肤表皮层,病变基底光滑,与真皮层分界清晰,内未见或仅见少量血流信号。BCC和SCC好发于头面部等曝光部位,均可表现为低回声病变,基底部边界不清,侵及真皮层或皮下组织,BCC内可见多发特征性点状高回声,而SCC体积较大、浸润更深、血流信号更丰富。 |
| 英文摘要: |
| Objective To observe clinical and sonographic features of skin basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and seborrheic keratoses (SK). Methods Data of 68 patients with BCC (69 lesions), 44 with SCC (44 lesions) and 27 with SK (28 lesions) were retrospectively analyzed, and the clinical and sonographic features were explored. Results The proportion of lesions located at exposure areas such as head and face in BCC group and SCC group were both higher than that in SK group (both P＜0.017). Significant differences of the maximum diameter, involved depth, involved skin layer, shape, multiple hyperechoic spots, basal boundary, posterior echo, blood flow signal and lymph node metastasis were found among 3 groups (all P＜0.05). The maximum diameter and involved depth of lesions in SK group were greater than those in BCC and SK groups (all P＜0.017), the proportion of regular shaped lesions in SK group was higher than that in SCC group (P＜0.017). Multiple hyperechoic spots were only observed in BCC group (all P＜0.017), while the incidence of lymph node metastasis in SCC group was higher than that in BCC group (P＜0.017). Most SK lesions only involved the epidermis with clear basal boundary, while most BCC and SCC lesions involved the dermis or subcutaneous tissue (both P＜0.017). SCC lesions were more likely to invade the subcutaneous tissue compared with BCC (P＜0.017). SK lesions had no or only a small amount of blood flow signals, while most BCC lesions had moderate blood flow signals and most SCC lesions had rich blood flow signals (all P＜0.017). Conclusion Skin SK could develop in multiple parts of body, only involving the epidermal layer of skin, with a smooth base with clear boundary, no or only a small amount of blood flow signals. BCC and SCC tended to occur in exposure areas, both presented as hypoechoic lesions, with not clear basal boundary and blood flow signals, and invaded the dermis or subcutaneous tissue. Multiple characteristic hyperechoic spots could be seen in BCC, while SCC had larger volume, deeper infiltration and richer blood flow signals. |
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