背景:痣皮脂腺(NS)是一种罕见的先天性皮肤病变,约占所有新生儿的0.3%。虽然是良性的,NS病变可携带恶性继发性肿瘤。已发表的这些恶性肿瘤的发展速度各不相同。这项荟萃分析旨在确定NS中恶性和良性继发性肿瘤的发生率。
方法:使用PubMed进行了文献检索,Embase,和WebofScience从成立到2023年4月。合格的研究报告了NS患者继发性肿瘤的发生率或风险。两名独立审稿人筛选了研究,提取的数据,并评估纳入研究的质量。主要结果是继发性肿瘤的合并发生率。样本量大于50例的研究符合使用随机效应模型进行荟萃分析的条件。
结果:确定了28项研究,其中22人符合荟萃分析的条件。继发性肿瘤的总发生率为12.8%(95%置信区间[Cl],9.2%-17.6%)。恶性和良性肿瘤的发生率分别为2.4%(95%CI,1.4%-4.1%)和10.3%(95%CI,7.5%-13.9%),分别。基底细胞癌的发展率为1.7%(95%CI,0.9%-3.2%),而乳头状syrago囊腺瘤的发生率为3.6%(95%CI,2.5%-5.3%),而毛囊母细胞瘤的发生率为2.6%(95%CI,1.7%-3.8%)。
结论:尽管原发性NS病灶内恶性肿瘤的发生率很低,这是不可忽视的。预防性早期切除仍然是预防继发性恶性肿瘤的可行方法。解决化妆品和功能性并发症,并预先考虑到未来复杂重建的需要。我们建议,在适当的患者中,切除儿童的NS病变仍然是合理的一线选择,请记住,它可能会留下不良的疤痕。
BACKGROUND: Nevus sebaceous (NS) is a rare congenital skin lesion affecting approximately 0.3% of all newborns. Although benign, NS lesions can harbor malignant secondary tumors. The published rate of development of these malignant tumors varies. This meta-analysis aimed to identify the rate of malignant and benign secondary neoplasms occurring in NS.
METHODS: A literature search was conducted using PubMed, Embase, and Web of Science from inception to April 2023. Eligible studies reported incidence or risk of secondary neoplasms in patients with NS. Two independent reviewers screened studies, extracted data, and assessed the quality of included studies. The primary outcome was the pooled incidence of secondary neoplasms. Studies with sample sizes greater than 50 patients were eligible for meta-analysis using the random-effects model.
RESULTS: Twenty-eight studies were identified, 22 of which were eligible for meta-analysis. The overall rate of secondary neoplasms was 12.8% (95% confidence interval [Cl], 9.2%-17.6%). The rates of development of malignant and benign tumors were 2.4% (95% CI, 1.4%-4.1%) and 10.3% (95% CI, 7.5%-13.9%), respectively. The rate of development of basal cell carcinoma was 1.7% (95% CI, 0.9%-3.2%), whereas the rate of the development of syringocystadenoma papilliferum was 3.6% (95% CI, 2.5%-5.3%) and that if trichoblastoma was 2.6% (95% CI, 1.7%-3.8%).
CONCLUSIONS: Although the rate of development of malignant tumors within a primary NS lesion is low, it is not negligible. Prophylactic early excision remains a viable approach to prevent secondary malignant neoplasms, address cosmetic and functional complications, and preempt the need for complex reconstruction in the future. We propose that resection of NS lesions in childhood remains a reasonable first-line option in the appropriate patient keeping in mind that it may leave an undesirable scar.