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首页> 外文期刊>BMC Family Practice >Value of histopathologic analysis of subcutis excisions by general practitioners
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Value of histopathologic analysis of subcutis excisions by general practitioners

机译：全科医生对皮下切除术进行组织病理学分析的价值

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Background Only around 60% of skin lesions excised by GPs are referred to a pathologist. Clinical diagnoses of skin excisions by GPs may not be very accurate. Subcutis excisions are rarely done by GPs, and there is hence little information in the literature on the histopathological yield of subcutis excisions by GPs with regard to malignancies. The aim of this study was to evaluate the yield of histopathological investigation of a relatively large group of subcutis excisions by GPs, with special emphasis on discrepancies between clinical and histopathological diagnoses of malignancy. Methods We investigated a series of 90 subcutis excisions, which was derived from a database of consecutive GP submissions from the years 1999–2000 where in the same time period 4595 skin excisions were performed by the same group of GPs. This underlines the apparent reluctance of GPs to perform subcutis excisions. Results The final diagnosis was benign in 88 cases (97.8%) and malignant in 2 cases (2.2%). Seven cases had no clinical diagnosis, all of which were benign. Of the 83 clinically benign cases, 81 (97.6%) were indeed benign and 2 (2.4%) were malignant: one Merkel cell carcinoma and one dermatofibrosarcoma protuberans. The former was clinically thought to be a lipoma, and the latter a trichilemmal cyst. The dermatofibrosarcoma protuberans presented at the age of 27, and the Merkel cell carcinoma at the age of 60. Both were incompletely removed and required re-excision by a surgical oncologist. Conclusion Histopathological investigation of subcutis excisions by GPs yields unexpected and rare malignancies in about 2% of cases that may initially be excised inadequately. Based on these data, and because of the relatively rareness of these type of excisions, it could be argued that it may be worthwhile to have all subcutis excisions by GPs routinely investigated by histopathology.
机译：背景技术GPs切除的皮肤病变中只有约60％被转介给病理学家。 GP对皮肤切除的临床诊断可能不太准确。 GP很少进行皮下切除术，因此，关于恶性肿瘤，GP皮下切除术的组织病理学产量方面的文献资料很少。这项研究的目的是评估由GP进行的相对较大的皮下组织切除的组织病理学调查的结果，特别着重于恶性肿瘤的临床诊断与组织病理学诊断之间的差异。方法我们调查了90例皮下切除，这些切除是从1999-2000年连续提交GP的数据库中获得的，在同一时期内，同一组GP进行了4595例皮肤切除。这突显了全科医生显然不愿意进行皮下切除。结果最终诊断为良性88例（97.8％），恶性2例（2.2％）。 7例无临床诊断，均为良性。在83例临床良性病例中，有81例（97.6％）确实是良性的，而2例（2.4％）是恶性的：1例默克尔细胞癌和1例皮肤纤维肉瘤。在临床上，前者被认为是脂肪瘤，而后者被认为是三足囊肿。隆突性皮肤皮肤肉瘤在27岁时出现，默克尔细胞癌在60岁时出现。两者均未完全切除，需要由外科肿瘤科医生再次切除。结论GPs对皮下切除术的组织病理学调查显示，在大约2％最初可能未充分切除的病例中，产生了意料不到的罕见恶性肿瘤。基于这些数据，并且由于这类切除术的相对稀少，可以认为，由GP常规对所有皮下切除术进行组织病理学检查可能是值得的。

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