Aims To determine the distribution of three different intraepithelial growth patterns (pagetoid, bowenoid and papillary) in eyelid sebaceous carcinoma (SC) and correlate them with the clinical characteristics and prognosis. Methods A retrospective cohort study. The medical charts and pathological sections were retrospectively reviewed. All eligible patients were followed up for recurrence, metastasis and tumour-related mortality. The clinical significance of each intraepithelial growth pattern was determined by Cox regression. Results Of the 214 patients, 67 (31%) presented with intraepithelial invasion, among them, 34 (16%) were pagetoid, 27 (13%) were bowenoid and 6 (2.8%) were papillary. Patients of pagetoid intraepithelial spread showed significantly longer diagnostic delay (p=0.001) and more initial misdiagnoses of blepharitis (p=0.035). After a median follow-up period of 34.0 months, 67 (46%) patients in the non-intraepithelial group, 17 (50%) in the pagetoid group, 8 (30%) in the bowenoid group and 2 (33%) in the papillary group recurred. And 30 (20%) patients in the non-intraepithelial group, 9 (27%) in the pagetoid group and 4 (15%) in the bowenoid group developed metastasis. Moreover, 15 (10%) patients in the non-intraepithelial group, 6 (18%) in the pagetoid group and 1 (3.7%) in the bowenoid group died of SC. Cox regression indicated that pagetoid intraepithelial growth pattern was remarkably associated with increased chances of tumour-related mortality (HR=2.95, 95% CI 1.14 to 7.64, p=0.026). Conclusions Intraepithelial tumour invasion was presented in nearly one third of patients with eyelid SC. Pagetoid intraepithelial neoplasia, the predominant growth pattern, significantly increased the risk of tumour-related mortality. Meticulous histopathological intraepithelial examination is recommended for every patient of eyelid SC. Special attention should be paid to those with pagetoid invasion, who may require more intensive managements. Data are available upon reasonable request. Our data are available upon reasonable request.

中文翻译：

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眼睑皮脂腺癌的上皮内生长模式：来自单一机构的 214 名患者队列

目的 确定眼睑皮脂腺癌 (SC) 中三种不同上皮内生长模式（pagetoid、bowenoid 和 papillary）的分布，并将其与临床特征和预后相关联。方法回顾性队列研究。对病历和病理切片进行回顾性审查。所有符合条件的患者都接受了复发、转移和肿瘤相关死亡率的随访。通过 Cox 回归确定每种上皮内生长模式的临床意义。结果 214例患者中67例（31%）表现为上皮内浸润，其中佩特样34例（16%），鲍氏样27例（13%），乳头样6例（2.8%）。pagetoid 上皮内扩散的患者表现出明显更长的诊断延迟 (p=0.001) 和更多的睑缘炎初始误诊 (p=0.035)。在中位随访 34.0 个月后，非上皮内组 67 名 (46%) 患者、佩特样组 17 名 (50%) 患者、鲍温样组 8 名 (30%) 患者和非上皮内组 2 名 (33%) 患者乳头状群复发。非上皮内组30例（20%）、pagetoid组9例（27%）和鲍温样组4例（15%）发生转移。此外，非上皮内组 15 例 (10%) 患者、佩特样组 6 例 (18%) 和鲍温样组 1 例 (3.7%) 死于 SC。Cox 回归表明 pagetoid 上皮内生长模式与肿瘤相关死亡率的增加显着相关（HR=2.95，95% CI 1.14 至 7.64，p=0.026）。结论 近三分之一的眼睑 SC 患者存在上皮内肿瘤浸润。Pagetoid 上皮内瘤变，主要的生长模式，显着增加了肿瘤相关死亡率的风险。建议对每位眼睑 SC 患者进行细致的组织病理学上皮内检查。应特别注意那些有 pagetoid 入侵的人，他们可能需要更严格的管理。可根据合理要求提供数据。我们的数据可应合理要求提供。