基底细胞癌（BCC）是最常见的人类癌症。尽管有手术和局部治疗可供选择，但手术仍然是主要的治疗方法，导致费用较高。我们需要对 BCC 进行准确的风险评估，以便以患者为中心来制定治疗计划。在本研究中，我们将回顾有关 BCC 管理指南的文献，并分析高风险 BCC 的潜在指标。利用这种风险评估方法，我们将提出能够更有效地优化治疗的途径。本文提出了来自参与治疗简单和复杂基底细胞癌病例的皮肤癌专家和诊所的观点。它解决了在任何治疗或手术之前与准确风险分层相关的关键挑战。本研究回顾了高危 BCC 的不同免疫组织化学和血管生成标记物。 BCC 内白细胞介素 6、血管内皮生长因子和肥大细胞的表达与其侵袭性相关。其他免疫组织化学标记物，如 Cyclin D1 和 Bcl-2，也发挥着重要作用 - 与非侵袭性变体相比，Cyclin D1 在侵袭性 BCC 中较高，而 Bcl-2 在侵袭性 BCC 中较低。我们将得出结论，使用免疫组织化学和血管生成标记物进行基底细胞癌的风险评估和分层可以帮助优化治疗，确保仅在必要时使用外科手术。©Sharad Paul，Allanah Knight。最初发表于 JMIR Dermatology (http://derma.jmir.org)，2023 年 10 月 30 日。

Basal cell carcinoma (BCC) is the most common human cancer. Although there are surgical and topical treatments available, surgery remains the mainstay of treatment, leading to higher costs. What is needed is an accurate risk assessment of BCC so that treatments can be planned in a patient-centered manner.In this study, we will review the literature about guidelines for the management of BCC and analyze the potential indicators of high-risk BCC. Using this risk assessment approach, we will propose pathways that will be able to optimize treatments more efficiently.This paper presents a perspective from a skin cancer expert and clinic involved in the treatment of both simple and complex cases of BCC. It addresses the key challenges associated with accurate risk stratification prior to any treatment or procedure. Different immunohistochemical and angiogenic markers for high-risk BCC were reviewed in this study.The expression of interleukin-6, vascular endothelial growth factor, and mast cells within BCC correlates with its aggressiveness. Other immunohistochemical markers, such as Cyclin D1 and Bcl-2, also play a significant role-Cyclin D1 is higher in the aggressive BCC, while Bcl-2 is lower in the aggressive BCC, compared to the nonaggressive variants.Based on our research, we will conclude that using immunohistochemical and angiogenic markers for risk assessment and stratification of BCC can help optimize treatment, ensuring that surgical procedures are used only when necessary.©Sharad Paul, Allanah Knight. Originally published in JMIR Dermatology (http://derma.jmir.org), 30.10.2023.