皮肤瘢痕癌45例回顾性分析

Skin scar carcinoma:a review and analysis of 45 cases

目的:探讨瘢痕癌的临床特点、诊断和治疗方法。方法:回顾性分析我科1978年1月～2008年1月经病理确诊的45例瘢痕癌患者临床资料。结果:45例均为慢性瘢痕癌,其中溃疡型36例,增生型9例;年龄大于50岁的37例,占82.22%;烧伤瘢痕癌最多见,占40%;皮损好发于四肢(44.44%),其次为头面部(42.22%),躯干部最少(13.33%);皮损恶变的潜伏期为3～60年,平均(30.7±16.3)年;相关分析进一步证实,原发病诊断时的年龄与潜伏期呈显著的负相关;2例(4.44%)烧伤瘢痕癌发生腹股沟淋巴结转移;组织病理学检查所有病例均为鳞状细胞癌。结论:瘢痕癌主要见于50岁以上患者,组织病理学检查是确定诊断瘢痕癌的重要依据,根治性切除术是瘢痕癌的首选治疗方法,早期诊断、早期治疗是预防瘢痕癌的重要措施。

Objective To investigate the clinical manifestation,diagnosis and treatment of skin scar carcinoma.Methods During the last 30 years in our department of dermatology,forty-five patients with skin scar carcinoma have been detected by histopathologic examination.Results All patients belonged to chronic scar carcinoma.Among them,36 cases were ulcer type and proliferative lesions 9 cases.Thirty-seven patients（82.22%）were more than 50 years old.About 40%were burn scar carcinoma.Most lesions of scar carcinoma occur on the extremities（44.44%）,on the head and face occurring less frequently（42.22%）and those on the trunk that are the least frequent（13.33%）.The mean latent period for malignant transformation was（30.7±16.3）years.The latent period of skin scar carcinoma was inversely proportionate to the age at the time of injury.Only 2 patients（4.44%）with burn scar carcinoma had groin lymph node metastasis.Malignancy was all squamous cell carcinoma.Conclusions Skin scar carcinoma was mainly detected in patients with more than 50 years old.Biopsy is the definitive diagnostic tool.Wide resection is the first choice to treat the scar carcinoma.Early diagnosis and early treatment are important for prevention of skin scar carcinoma.