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Vol. 109. Num. 1.January - February 2018
Pages e1-e6Pages 1-94
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Vol. 109. Num. 1.January - February 2018
Pages e1-e6Pages 1-94
Original Article
DOI: 10.1016/j.adengl.2017.08.023
Correlation Between Incisional Biopsy Histological Subtype and a Mohs Surgery Specimen for Nonmelanoma Skin Cancer
Correlación entre el subtipo histológico de la biopsia incisional y una muestra de cirugía de Mohs en el cáncer de piel no melanoma
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E.C. Cortés-Peralta, J. Ocampo-Candiani
Corresponding author
jocampo2000@yahoo.com.mx

Corresponding author.
, O.T. Vázquez-Martínez, I.M. Gutiérrez-Villarreal, I. Miranda-Maldonado, V. Garza-Rodríguez
Dermatology Department, Hospital Universitario Dr. José E. González, Monterrey, Nuevo León, Mexico
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Tables (6)
Table 1. Histological types and subtypes of NMSC.
Table 2. Location of tumours.
Table 3. Distribution of NMSC cases on incisional biopsy by histological subtype.
Table 4. Summary of diagnoses from tumour layer examination during Mohs micrographic surgery diagnosed by Mohs surgeon and preoperative biopsy diagnosis.
Table 5. Correlation between the preoperative biopsy subtype and the histologic defined by both a Mohs surgeon and a pathologist.
Table 6. Correlation between the preoperative biopsy subtype and the histologic subtype defined by the Mohs surgeon.
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Abstract
Background

Histological diagnosis of a clinically suspected nonmelanoma skin cancer (NMSC) is recommended before treatment. For NMSC, concordance between the histological subtype of the preoperative biopsy and the excision specimen of basal cell carcinoma (BCC) has been reported to range from 10% to 81%. No large study on the concordance between NMSC histology seen in a preoperative biopsy with the following tumour specimen from Mohs micrographic surgery (MMS) has been performed in a Latin American population.

Objective

The aim of this study was to analyse and compare the histological subtype of the incisional biopsies reviewed by the dermatopathologist with the histological subtype of the tumour specimen obtained during MMS interpreted by the dermatopathologist and the Mohs surgeon.

Methods

A retrospective analysis of 320 NMSC was performed. The interobserver correlation was based on kappa values.

Results

The mean weighted kappa value between the preoperative NMSC biopsy and intraoperative histological subtype of the tumour specimen from MMS analysed by the Mohs surgeon and the dermatopathologist was 0.22 and 0.24, respectively. The correlation in the histologic subtype of the intraoperative tumour specimen from MMS that was interpreted by the dermatopathologist and Mohs surgeon was 0.58.

Conclusions

Dermatologists need to be aware of the limited value of incisional biopsies to accurately diagnose the histological subtype of a NMSC. The concordance rate in the histological diagnosis of the tumour specimens that were obtained from MMS between the Mohs surgeon and the dermatopathologist is moderate. However, the correlation is low compared with incisional biopsy subtypes.

Keywords:
Mohs surgery
Biopsy
Concordance
Correlation
Dermatopathology
Carcinoma
Histology
Skin surgery
Resumen
Antecedentes

Se recomienda diagnosticar histológicamente el cáncer cutáneo no melanoma clínicamente sospechado (CCNM) antes de iniciar el tratamiento. Para el CCNM, se ha reportado una concordancia entre el subtipo histológico de la biopsia preoperatoria y la muestra extirpada del carcinoma de células basales (CCB), que oscila entre el 10 y el 81%. No se han llevado a cabo grandes estudios sobre la concordancia entre la histología del CCNM apreciada en la biopsia preoperatoria y la siguiente muestra tumoral obtenida de la cirugía micrográfica de Mohs (MMS) en la población latinoamericana.

Objetivo

El objetivo de este estudio fue analizar y comparar el subtipo histológico de las biopsias incisionales revisadas por el dermato-patólogo, con el subtipo histológico de la muestra tumoral obtenida durante la MMS, interpretada por el dermato-patólogo y el cirujano.

Métodos

Se realizó un análisis retrospectivo de 320 CCNM. La correlación inter-observador se basó en los valores kappa.

Resultados

El valor medio ponderado kappa entre la biopsia preoperatoria del CCNM y el subtipo histológico intraoperatorio de la muestra tumoral obtenida de la MMS, analizadas por el cirujano y el dermato-patólogo, fue de 0,22 y 0,24, respectivamente. La correlación en el subtipo histológico de la muestra tumoral intraoperatoria para MMS, interpretada por el dermo-patólogo y el cirujano, fue de 0,58.

Conclusiones

Los dermatólogos deben ser conscientes del valor limitado de las biopsias incisionales para diagnosticar de manera precisa el subtipo histológico del CCNM. La tasa de concordancia del diagnóstico histológico de las muestras tumorales obtenidas durante la MMS, entre el cirujano y el dermato-patólogo, fue moderada. Sin embargo, la correlación es baja cuando se compara con los subtipos obtenidos de la biopsia incisional.

Palabras clave:
Cirugía de Mohs
Biopsia
Concordancia
Correlación
Dermatopatología
Carcinoma
Histología
Cirugía de piel

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