皮肤鳞状细胞癌1例及系统综述

发布时间：2018-07-25 06:25

【摘要】：目的报告1例老年面部中低分化的鳞状细胞癌,并系统性回顾国内关于皮肤鳞状细胞癌病例报告文献。方法对该病例进行详细的临床及实验室检查及活检,行扩大切除术后随访至今。并检索近10年内国内关于皮肤鳞状细胞癌的报告文献建立数据库进行描述性分析。结果患者男,75岁。4个月前右颧部出现直径约0.5cm的红斑,伴轻微触痛,冷冻治疗后逐渐扩大至直径为2cm,表面破溃,外用抗生素药膏治疗无效,皮损活检提示为中低分化鳞状细胞癌,行扩大切除术1年后随访,无复发。共获得该类病例报告文献181篇,涉及208例患者,其中男149例,女59例,各年龄段均有报道,以中老年患者多见(45岁以上者150例,占72.12%);其在国内南北方地区报道数量相近。病程20d~40年,皮损多见于光暴露部位,50.00%患者出现溃疡,21.63%伴有触痛,55.77%有原发病史,29.81%提及误诊,其中约半数误诊为皮肤感染(43.55%),5.77%出现远隔转移。结论光暴露部位出现触痛或破溃性皮损时,应高度警惕鳞状细胞癌的可能。该病误诊率高,及时行组织病理检查有助于本病早期诊断及治疗。
[Abstract]:Objective to report a case of poorly differentiated squamous cell carcinoma (SCC) in the elderly and to systematically review the domestic literature on cases of squamous cell carcinoma of skin (SCC). Methods detailed clinical and laboratory examination and biopsy were performed, followed up after extended excision. In the last 10 years, a database was established for descriptive analysis of domestic reports on cutaneous squamous cell carcinoma (SCC). Results the male was 75 years old. Four months ago, the right zygomaticus had erythema of about 0.5cm diameter, with slight tenderness. After cryotherapy, the diameter was gradually expanded to 2 cm, the surface was broken, and the external antibiotic ointment was not effective. The lesion biopsy showed low-differentiated squamous cell carcinoma. No recurrence occurred after extensive resection for 1 year. A total of 181 cases were reported, involving 208 patients, including 149 males and 59 females. Among them, 150 cases (72.12%) were reported in middle and old age (150 cases over 45 years old), and the number of reports was similar in the north and south regions of China. From 20 days to 40 years, the skin lesions were found in 50.00% of the patients with ulceration and tenderness, 55.77% had the history of primary disease, 29.81% mentioned misdiagnosis, about half of them were misdiagnosed as skin infection (43.55%) and 5.77% had distant metastasis. Conclusion the possibility of squamous cell carcinoma (SCC) should be on the alert when there is tenderness or ruptured lesion in the exposed area of light. The misdiagnosis rate of the disease is high, and timely histopathological examination is helpful to the early diagnosis and treatment of the disease.
【作者单位】：北京大学第三医院皮肤科;北京大学医学部病理科;
【基金】：北京高等学校青年英才计划项目(YETP0072)
【分类号】：R739.5

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