Diagnosis of aggressive subtypes of eyelid basal cell carcinoma by 2-mm punch biopsy: prospective and comparative study

ABSTRACT Objective : to compare the accuracy of preoperative 2-mm punch biopsy at one site and at two sites in the diagnosis of aggressive subtypes of eyelid basal cell carcinoma (BCC). Methods : we randomly assigned patients to Group 1 (biopsy at one site) and Group 2 (biopsy at two sites). We compared the biopsy results to the gold standard (pathology of the surgical specimen). We calculated the sensitivity, specificity, positive predictive value, negative predictive value, accuracy and Kappa coefficient to determine the level of agreement in both groups. Results : we analyzed 105 lesions (Group 1: n = 44; Group 2: n = 61). The agreement was 54.5% in Group 1 and 73.8% in Group 2 (p = 0.041). There was no significant difference between the groups regarding the distribution of quantitative and qualitative variables (gender, age, disease duration, tumor larger diameter, area and commitment of margins). Biopsy at two sites was two times more likely to agree with the gold standard than the biopsy of a single site. Conclusions : the accuracy and the performance indicators were better for 2-mm punch biopsy in two sites than in one site for the diagnosis of aggressive subtypes of eyelid BCC.

摘要
研究目的：对比单部位与双部位术前2mm环钻活检（2-mm punch biopsy）在侵袭性眼睑基底细胞癌（basal cell carcinoma, BCC）亚型诊断中的准确性。
研究方法：将患者随机分配至第1组（单部位活检）与第2组（双部位活检），将活检结果与金标准（手术标本病理学检测结果）进行比对，通过计算两组的灵敏度、特异度、阳性预测值、阴性预测值、准确率及Kappa系数（Kappa coefficient），评估二者的诊断一致性水平。
研究结果：共分析105处病变（第1组：n=44；第2组：n=61）。第1组诊断一致性为54.5%，第2组为73.8%（p=0.041）。两组在性别、年龄、病程、肿瘤最大直径、病变面积及边缘受累情况等定量与定性变量的分布上均无显著差异。双部位活检与金标准的符合率为单部位活检的2倍。
研究结论：针对侵袭性眼睑基底细胞癌（BCC）亚型的诊断，双部位2mm环钻活检的准确率及各项性能指标均优于单部位活检。