Background

Pathology reports of basal cell carcinoma (BCC) biopsies often contain comments of positive or negative margins, with only 1%-2% of the margin evaluated. The negative predictive value (NPV) of biopsy margin status on residual BCC is unknown.

Objective

The purpose of this study was to determine the NPV of BCC biopsy margin status on the absence of residual BCC in the corresponding excision.

Methods

From our institution's archives, we collected BCC biopsies with negative margin readings that had subsequent excisions. For excisions read as negative for residual BCC, the excision blocks were sectioned at 150-μm intervals until exhausted.

Results

We collected 143 cases that met criteria; 34 (24%) were found to contain residual BCC in the corresponding excision leading to a NPV of 76%; in 31 of 34 (91%) of these cases, the residual histologic subtype was superficial.

Limitations

Our sectioning technique did not evaluate 100% of the excision specimens.

Conclusion

Negative margins in a BCC biopsy are a poor predictor of residual disease in the patient. We recommend that clinicians treat these lesions, and that pathologists who comment on margin status of BCC biopsies consider adding a caveat to reflect these findings.

中文翻译：

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阴性边缘的基底细胞癌活检的预测价值：一项回顾性队列研究

背景

基底细胞癌（BCC）活检的病理报告通常包含阳性或阴性切缘的注释，仅评估了1％-2％的切缘。残留的BCC的活检边缘状态的阴性预测值（NPV）是未知的。

客观的

这项研究的目的是确定在相应切除中没有残留BCC的情况下BCC活检边缘状态的NPV。

方法

从我们机构的档案中，我们收集了BCC活检，其边缘读数为负，随后进行了切除。对于切除为残留BCC阴性的切除，将切除块以150μm的间隔进行切片，直到用尽。

结果

我们收集了143个符合标准的案例；发现34例（24％）在相应的切除中含有残留的BCC，导致NPV为76％；在这些病例中，有34个病例中有31个（91％）的残余组织学亚型是浅表的。

局限性

我们的切片技术未评估100％的切除标本。

结论

BCC活检的切缘阴性不能很好地预测患者残留疾病。我们建议临床医生对这些病变进行治疗，建议对BCC活检的切缘状态发表评论的病理学家考虑添加警告以反映这些发现。