Skin cancer detection indicators

Skin cancer is becoming more and more common in today's prosperous chemical industry. Water pollution, air ozonation, light pollution, etc. are all causes of skin cancer. So how much do we know about skin cancer? The following are the main symptoms and categories of skin cancer.

Diagnosis relies on biopsy, but the diagnostician must have sufficient experience to identify suspected malignant lesions. The following are highly suspected early malignant lesions: skin ulcers that do not heal for a long time or come and go or have a small amount of bleeding, and any solar keratosis that has bleeding, ulceration, or asymmetric nodules. Skin or old scars that have been exposed to radiation in the past, or ulcers or nodules in the sinus. Red skin scars that do not fade for a long time and show mild erosion should be alert to the possibility of carcinoma in situ.

For smaller lesions, multiple excisional biopsies are performed, which can achieve both diagnosis and treatment at one stroke. For larger lesions, especially when the treatment requires excision of 2 to 3 mm of normal skin outside the lesion edge, and the defect is too large to cause appearance defects, forceps or incisional biopsies are performed, remembering to include the proximal part of the lesion.

Skin cancer includes basal cell carcinoma, squamous cell carcinoma, malignant melanoma, malignant lymphoma, idiopathic hemorrhagic sarcoma (Kaposi sarcoma), sweat gland carcinoma, dermatofibrosarcoma protuberans, angiosarcoma, etc.

Histopathological examination has a definite significance for the diagnosis and classification of skin cancer and is easy to operate. The histopathology of basal cell carcinoma and squamous cell carcinoma is described as follows:

1) Basal cell carcinoma: There are clearly bordered tumor cell groups in the dermis. The nuclei are slightly larger than normal, oval or long, with less cytoplasm, unclear boundaries between cells, and no bridges between cells. Therefore, it seems that many nuclei are densely distributed in a common serous fluid, and there is no significant difference in nuclear staining. Sometimes, cells with multiple nuclei or darkly stained nuclei or irregular stellate nuclei can be seen. Connective tissue proliferates around the tumor cell group, and plug cells are arranged in a palisade shape in the outermost layer. Many immature fibroblasts and mature fibroblasts are often seen mixed around the tumor tissue. The stroma of basal cell carcinoma contains mucin. When the slices are made, the stroma shrinks, causing the stroma to separate from the edge of the tumor mass in a fissure-like manner, which is of certain significance for the diagnosis of this disease. In histopathology, basal cell carcinoma can be divided into two major categories: differentiated type and undifferentiated type. The undifferentiated type can be manifested as solid type, pigmented type, fibrotic type, or hard plaque-like, superficial type. Solid type can be seen with different amounts of tumor masses of different shapes buried in the dermis; pigmented type has more melanin between tumor cells; fibrotic or hard plaque type has significant connective tissue hyperplasia, connective tissue wraps around tumor cell groups in bundles; superficial type has more short bud-shaped tumor cell groups under the epidermis. Differentiated type can have keratinizing basal cell carcinoma that differentiates into hair structure, cystic basal cell carcinoma that differentiates into sebaceous glands, glandular basal cell carcinoma that differentiates into apocrine glands, etc.

2) Squamous cell carcinoma: Cancer cells invade the dermis in clusters or cords, with varying numbers of normal and atypical incompletely differentiated squamous cells and dyskeratinized cells. The more atypical squamous cells there are, the higher the malignancy, which is manifested by unequal cell sizes, atypical nuclear divisions, dark staining, basophilic cytoplasm, and no intercellular bridges. The more differentiated the squamous cells are, the more keratinized they are as they approach the center, and the center can be completely keratinized. Squamous cell carcinoma can be divided into four degrees according to the proportion of atypical squamous cells in the tumor.

Grade I squamous cell carcinoma: The tumor tissue does not exceed the level of the sweat glands, the atypical squamous cells are less than 25%, there are many horn beads, and there is obvious inflammatory reaction in the dermis;

Grade II squamous cell carcinoma: The cancer cell clusters have unclear boundaries, atypical squamous cells account for about 20% to 50%, there are only a few corner beads, the center of the corner beads is not fully keratinized, and the surrounding inflammatory reaction is mild;

Grade III squamous cell carcinoma: about 50% to 75% of the cells are atypical squamous cells, most of which are not keratinized, have no horn beads, and the surrounding inflammatory reaction is not significant;

Grade IV squamous cell carcinoma: Atypical squamous cells account for more than 75%, with many mitotic figures, no intercellular bridges, and no horns.

For patients with skin diseases, the first thing to do is to be admitted to the hospital for treatment in time. In addition, the source of pollution must be isolated in time. In fact, skin cancer will not affect life in the early stages, so we must ensure early detection and early treatment.