【摘要】：目的報告1例老年面部中低分化的鱗狀細(xì)胞癌,并系統(tǒng)性回顧國內(nèi)關(guān)于皮膚鱗狀細(xì)胞癌病例報告文獻(xiàn)。方法對該病例進(jìn)行詳細(xì)的臨床及實驗室檢查及活檢,行擴(kuò)大切除術(shù)后隨訪至今。并檢索近10年內(nèi)國內(nèi)關(guān)于皮膚鱗狀細(xì)胞癌的報告文獻(xiàn)建立數(shù)據(jù)庫進(jìn)行描述性分析。結(jié)果患者男,75歲。4個月前右顴部出現(xiàn)直徑約0.5cm的紅斑,伴輕微觸痛,冷凍治療后逐漸擴(kuò)大至直徑為2cm,表面破潰,外用抗生素藥膏治療無效,皮損活檢提示為中低分化鱗狀細(xì)胞癌,行擴(kuò)大切除術(shù)1年后隨訪,無復(fù)發(fā)。共獲得該類病例報告文獻(xiàn)181篇,涉及208例患者,其中男149例,女59例,各年齡段均有報道,以中老年患者多見(45歲以上者150例,占72.12%);其在國內(nèi)南北方地區(qū)報道數(shù)量相近。病程20d~40年,皮損多見于光暴露部位,50.00%患者出現(xiàn)潰瘍,21.63%伴有觸痛,55.77%有原發(fā)病史,29.81%提及誤診,其中約半數(shù)誤診為皮膚感染(43.55%),5.77%出現(xiàn)遠(yuǎn)隔轉(zhuǎn)移。結(jié)論光暴露部位出現(xiàn)觸痛或破潰性皮損時,應(yīng)高度警惕鱗狀細(xì)胞癌的可能。該病誤診率高,及時行組織病理檢查有助于本病早期診斷及治療。
[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.
【作者單位】： 北京大學(xué)第三醫(yī)院皮膚科;北京大學(xué)醫(yī)學(xué)部病理科;
【基金】：北京高等學(xué)校青年英才計劃項目(YETP0072)
【分類號】：R739.5

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