74例皮肤鳞状细胞癌的临床与病理分析

Clinical and Pathology Analysis of 74 Cases Skin Squamous Cell Carcinoma

目的研究皮肤鳞状细胞癌的发病机制。方法对74例皮肤鳞状细胞癌病例进行回顾性分析,就其临床、病理、诊断、鉴别诊断以及病因等多方面因素,进行综合分析。结果 (1)74例皮肤鳞状细胞癌患者中发病年龄及男女构成比有显著差异(P<0.05),男性明显多于女性,且40岁及40岁以上患者多见。(2)发生于暴露部位以头面部最多,且在不同年龄间、不同职业间存在显著差异,农民居多(P<0.01)。(3)肿瘤中央有无溃疡形成,在男女间(P>0.05)及不同年龄段间无显著差异(P>0.05);在不同临床分型中,不存在显著差异(P>0.05);在性别及年龄段,也不存在显著差异(P>0.05);不同职业间发病部位存在显著差异(P<0.01),农民发生在暴露部位的以头面部居多(P<0.01)。(4)不同病理分型发病年龄和男女构成比无显著差异(P>0.05);各型中疣状型多见于生殖器部位(P<0.01),其余类型多见于头面部(P<0.01)。其中,溃疡皮损在不同病理分型中多见于Ⅰ级鳞癌(P<0.01),在不同部位中多见于头面部(P<0.01)。(5)各临床类型中,以结节隆起型最易误诊(P<0.05)。结论 (1)慢性长期反复的日光照射与皮肤SCC的发生有密切关系。(2)组织病理分型对于皮肤SCC的诊断、治疗及预后,有十分重要的作用。(3)深入认识皮肤SCC侵袭性及破坏性对人类健康的影响,可以促进临床医师对皮肤SCC的重视程度。

Objective To study the pathogenesis of skin squamous cell carcinoma（SCC）.Methods A rerospective analysis about the clinical,pathology,diagnosis,differential diagnosis,causes,prevertion have been done.Results（1）74 cases of SCC patients,there are significant difference in age of onset and male-female constitute ratio（P〈0.05）,males are more than females,40 years and older patients are particularly prevalent.（2）Face is the most common pate among exposed parts,and the differences are very significant in different ages and different occupations,over 40 years older are more common（P〈0.01）;farmers are up to see（P〈0.01）.（3）The tumors with ulcer taking place in the central has no difference in gender（P〉0.05） and different ages（P〉0.05）.The tumors in clinical criteria,has no significant differences（P〉0.05）;But there has significant differences between different occupations in the location of the tumors take place（P〈0.01）,and face is the most common part in farmers（P〈0.01）.（4）There are no significant differences between incidence of age male-female constitute ratio in defferent pathological types（P〈0.05）;in different pathological types,verrucous type is more common in generative organs（P〈0.01）,and other types is common in first face（P〈0.01）.The tumors which take place with ulcer is common in Ⅰtype（P〈0.01） and often take place in the first place（P〈0.01）.（5）The nodule type is most easily be misdiagnosed in all clinical types（P〉0.05）.Conclusion（1）Chronic and long-term solar exposure associated with the occurrence of SCC.（2）Histopathology typing is crucial for the diagnosis,treatment and judgment of the prognosis of SCC.（3）To understand the invasive and destructive of SCC to the human health could improve the degree of reconstruction of clinician.