北京协和医院29 987例皮肤活检组织的临床病理诊断构成

【摘要】 目的 分析北京协和医院皮肤活检组织的疾病构成及临床和病理诊断情况。方法 回顾北京协和医院皮肤科2010年6月至2018年11月采用皮肤组织病理检查的29 987例患者，分析组织病理和诊断情况。结果 根据病理诊断结果，将确诊的皮肤疾病分为33大类，242种。常见的疾病类别分别为表皮肿瘤（2 931例，9.77%）、结缔组织病（2 809例，9.37%）、黑素细胞性肿瘤（2 078例，6.93%）、红斑鳞屑脓疱性皮肤病（1 376例，4.59%）、苔藓样皮肤病（1 291例，4.31%）、变态反应和湿疹类（1 282例，4.28%）及感染性疾病（1 156例，3.86%）等。常见疾病为硬皮病（1 887例，6.29%）、色素痣（1 755例，5.85%）、脂溢性角化（1 136例，3.79%）、湿疹（1 089例，3.63%）、银屑病（881例，2.94%）、扁平苔藓（867例，2.89%）、红斑狼疮（638例，2.13%）、天疱疮（549例，1.83%）和基底细胞癌（501例，1.67%）等。扁平苔藓、大疱性类天疱疮、环状肉芽肿、嗜酸性粒细胞增多性皮病等的临床诊断不符合率高，与病理诊断的一致率较低。结论 本院皮肤活检组织中表皮肿瘤、结缔组织病、黑素细胞性肿瘤、红斑鳞屑脓疱性皮肤病、苔藓样皮肤病、变态反应和湿疹类占比高。部分皮肤病临床诊断与病理诊断一致率低，对此类疾病需提高认识。

Analysis of clinical and pathological diagnoses of 29987 skin biopsy samples in Peking Union Medical College Hospital

Objective To analyze the disease constitution,accuracy of clinical and pathological diagnoses of skin biopsy samples in Peking Union Medical College Hospital.Methods A total of 29987 patients subjected to skin biopsy were collected from Department of Dermatology,Peking Union Medical College Hospital from June 2010 to November 2018,and clinical and histopathological diagnoses of these skin biopsy samples were analyzed retrospectively.Results According to the results of histopathological diagnosis,confirmed diagnoses of these patients could be classified into 33 categories and 242 kinds.Common disease categories included epidermal tumors(2931 cases,9.77%),connective tissue diseases(2809 cases,9.37%),melanocytic tumors(2078 cases,6.93%),erythematous scaly pustular dermatoses(1376 cases,4.59%),lichenoid dermatoses(1291 cases,4.31%),allergic or eczematous skin diseases(1282 cases,4.28%)and infectious skin diseases(1156 cases,3.86%).Common skin diseases included scleroderma(1887 cases,6.29%),pigmented nevus(1755 cases,5.85%),seborrheic keratosis(1136 cases,3.79%),eczema(1089 cases,3.63%),psoriasis(881 cases,2.94%),lichen planus(867 cases,2.89%),lupus erythematosus(638 cases,2.13%),pemphigus(549 cases,1.83%),and basal cell carcinoma(501 cases,1.67%).Poor consistency was observed between clinical diagnosis and histopathological diagnosis of lichen planus,bullous pemphigoid,granuloma annulare and hypereosinophilic dermatitis.Conclusions Common disease categories of the skin biopsy samples in Peking Union Medical College Hospital were epidermal tumors,connective tissue diseases,melanocytic tumors,erythematous scaly pustular dermatoses,lichenoid dermatoses,and allergic or eczematous skin diseases.Poor consistency was observed between clinical and pathological diagnosis in some skin diseases,and understanding of these diseases should be improved.