外耳部皮肤原位及浸润性鳞状细胞癌30例临床病理分析
发布时间：2018-07-20 11:52
【摘要】：目的探讨外耳皮肤原位及浸润性鳞状细胞癌(invasive squamous cell carcinoma,i SCC)的临床病理学特征、诊断、鉴别诊断及预后因素。方法回顾性分析30例外耳皮肤鳞状细胞癌(cutaneous squamous cell carcinoma,c SCC)的临床病理学特征,并复习相关文献。结果 30例外耳c SCC患者男女比为4∶1,平均年龄66.9岁,中位年龄71岁。23例耳廓c SCC,7例外耳道c SCC。镜检:22例(73.3%)为浸润性鳞状细胞癌(invasive squamous cell carcinoma,i SCC);8例(26.7%)为原位鳞状细胞癌(squamous cell carcinoma in situ,SCCIS),其中2例可疑浸润。浸润癌中,19例为混合型c SCC,伴一种或多种特殊组织学亚型,其中10例伴棘层松解;8例伴梭形细胞区域;3例伴透明细胞区域;2例伴淋巴上皮瘤样癌特点;7例伴角化棘皮瘤样特点;1例与毛囊相关。外耳c SCC的首次活检确诊率约80.1%,外耳道c SCC的确诊率仅为57.1%。切缘阳性病例的局部复发率为66.7%(2/3),切缘阴性者局部复发率为10%(2/20)。20例随访病例中,2例(10%)伴颈部淋巴结转移,1例(5%)肺转移,5例(25%)死亡。结论外耳c SCC的组织学形态多样,病理诊断具有一定的局限性,其确诊需密切联系临床和影像学资料。外耳c SCC预后不良的因素主要包括肿瘤直径≥2 cm、浸润软骨、累及颅骨、分期较晚和切缘阳性等。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis, differential diagnosis and prognostic factors of (invasive squamous cell carcinoma in situ and invasive squamous cell carcinoma of external ear. Methods the clinicopathological features of 30 cases of (cutaneous squamous cell carcinomatous cell carcinoma (SCC) were retrospectively analyzed and the related literatures were reviewed. Results the male to female ratio of 30 cases with c SCC was 4: 1, with an average age of 66.9 years. The median age was 71 years. Twenty two cases (73.3%) were diagnosed as invasive squamous cell carcinoma (invasive squamous cell carcinoma), 8 cases (26.7%) were (squamous cell carcinoma in situ squamous cell carcinoma (squamous cell carcinoma in), and 2 cases were suspected invasion. In invasive carcinoma, 19 cases were mixed type c SCC with one or more special histological subtypes. Among them, 10 cases with spinous lamina and 8 cases with spindle cell region, 3 cases with clear cell region, 2 cases with lymphoepithelioma-like carcinoma, 7 cases with keratoacanthoma and 1 case with hair follicle. The diagnosis rate of c SCC in external ear was about 80.1%, and that of c SCC in external auditory canal was only 57.1%. The local recurrence rate of positive margin cases was 66.7% (2 / 3). The local recurrence rate of negative margin cases was 10% (2 / 20). Of the 20 cases followed up, 2 cases (10%) were followed up with cervical lymph node metastasis in 1 case (5%) and lung metastasis in 5 cases (25%). Conclusion the histopathology and pathological diagnosis of external ear c SCC are various. The diagnosis of c SCC should be closely related to clinical and imaging data. The main prognostic factors of external ear c SCC included tumor diameter 鈮，
本文编号：2133429
[Abstract]:Objective to investigate the clinicopathological features, diagnosis, differential diagnosis and prognostic factors of (invasive squamous cell carcinoma in situ and invasive squamous cell carcinoma of external ear. Methods the clinicopathological features of 30 cases of (cutaneous squamous cell carcinomatous cell carcinoma (SCC) were retrospectively analyzed and the related literatures were reviewed. Results the male to female ratio of 30 cases with c SCC was 4: 1, with an average age of 66.9 years. The median age was 71 years. Twenty two cases (73.3%) were diagnosed as invasive squamous cell carcinoma (invasive squamous cell carcinoma), 8 cases (26.7%) were (squamous cell carcinoma in situ squamous cell carcinoma (squamous cell carcinoma in), and 2 cases were suspected invasion. In invasive carcinoma, 19 cases were mixed type c SCC with one or more special histological subtypes. Among them, 10 cases with spinous lamina and 8 cases with spindle cell region, 3 cases with clear cell region, 2 cases with lymphoepithelioma-like carcinoma, 7 cases with keratoacanthoma and 1 case with hair follicle. The diagnosis rate of c SCC in external ear was about 80.1%, and that of c SCC in external auditory canal was only 57.1%. The local recurrence rate of positive margin cases was 66.7% (2 / 3). The local recurrence rate of negative margin cases was 10% (2 / 20). Of the 20 cases followed up, 2 cases (10%) were followed up with cervical lymph node metastasis in 1 case (5%) and lung metastasis in 5 cases (25%). Conclusion the histopathology and pathological diagnosis of external ear c SCC are various. The diagnosis of c SCC should be closely related to clinical and imaging data. The main prognostic factors of external ear c SCC included tumor diameter 鈮，
本文编号：2133429
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