包皮环切术后发生阴茎鳞状细胞癌17例报道

Penile Squamous Carcinoma in Circumcised Patients: A Report 17 Cases

目的：分析包皮环切术后发生的阴茎癌的诊治。方法：回顾性分析我院1997年1月-2004年12月行包皮环切术后1个月～16年发生阴茎癌17例患者的临床资料。结果：本组患者中术后1～12个月发现阴茎癌者11例，术后3～16年发现者6例；16例行阴茎部分切除术＋腹股沟淋巴结活检术，1例行扩大包皮环切术后复发相继行阴茎部分切除、全切术。复发的1例死亡，其余16例存活至今。结论：成年人行包皮环切术后仍有发生阴茎癌可能，对伴有包皮炎症、溃疡等病变的患者行包皮环切术应常规行病理检查，术后需密切随访，阴茎部分切除术是治疗早期阴茎鳞状细胞癌有效的方法，术中有必要行前哨淋巴结活检。

Objective： To discuss the diagnosis and treatment of penile carcinoma in circumcised men. Methods： We reviewed 17 cases of penile carcinoma detected 1 month to 16 years after circumcision performed in our hospital from January, 1997 to December, 2004. Results： Of the total number, 11 cases were diagnosed as penile carcinoma 1 - 12 months and the others 3 - 16 years after the circumcision. Sixteen of them were treated by partial penectomy, and 1 first by extensive circumcision and later by partial and total penectomy successively after recurrence. Cloquet＇s nodes biopsy showed 16 cases to be pathologically well-differentiated and 1 case moderately differentiated penile squamous carcinoma. One died of extensive metastasis, but the other 16 remained disease-free survivals. Conclusion ： Circumcised adult men, especially those over 40 years of age, are likely to develop penile carcinoma. Patients with inflammation, plaque or ulcer in the prepuce should be checked by pathological biopsy and followed up closely. For Stage-I penile squamous carcinoma, partial penectomy is shown to be an effictive therapeutic option, and Cloquet＇s nodes biopsy is necessary for all patients.