皮肤鳞状细胞癌300例临床及病理回顾分析

Clinical and Pathological Features of 300 Cases of Cutaneous Squamous Cell Carcinoma

目的探讨皮肤鳞状细胞癌(SCC)的临床及病理特征。方法回顾性分析总结2000年1月1日-2009年12月31日郑州大学第一附属医院经病理确诊的皮肤SCC首发病例的临床资料。结果该院10年共确诊皮肤SCC300例,男女比例约为1.86∶1。50岁及以上者223例(74.33%),暴露部位170例(56.67%)。临床诊断正确者52例(17.33%);诊断为恶性肿瘤、肿物待查和非肿瘤者分别为179例(59.67%)、45例(15.00%)和24例(8.00%)。300例SCC中病理学分级为高分化(Ⅰ级者)173例(57.67%)、高中分化(Ⅰ～Ⅱ级)39例(13.00%)、中分化(Ⅱ级)54例(18.00%)、中低分化(Ⅱ～Ⅲ级)19例(6.33%)、低分化(Ⅲ级)15例(5.00%)。结论皮肤SCC在河南省及其毗邻地区是一种少见疾病。男性患者接近女性的两倍,好发于中老年人。暴露部位比非暴露部位多发,且好发于头面部及外阴生殖器部位。高中分化SCC较低分化者常见。支持日光照射和HPV感染是SCC致病原因的学说。

Objective To investigate the clinicopathological features of cutaneous squamous cell carcinoma（SCC）.Methods All of cutaneous SCC in the Department of Pathology of the First Affiliated Hospital of Zhengzhou University from January 1,2000 to December 31,2009 were recruited and it＇s clinical and pathological features were summarized.Results Three hundred cutaneous SCCs were diagnosed in the 10 years＇ duration in the hospital.Among the 300 SCC patients,ratio of male to female was 1.86∶1.Two hundred and twenty-three（74.33%）cases were aged 50 and above.One hundred and seventy（56.67%）lesions were located on sun-exposed areas.Of the 300 cases,52（17.33%）cases had correct clinical diagnosis,other diagnoses such as malignant tumor,tumor with indefinite nature,or non-tumor were 179（59.67%）,45（15.00%）,and 24（8.00%）cases respectively.Pathological grade ofⅠ,Ⅰ～Ⅱ,Ⅱ,Ⅱ～Ⅲ and Ⅲ were 173（57.67%）,39（13.00%）,54（18.00%）,19（6.33%）and 15（5.00%）respectively.Conclusions Cutanesous SCC is a rare disease in Henan Province and its neighboring areas.It occurs in men about twice as frequently as in women,and usually suffer the elderly population.Sun-exposed and extragenital areas are two predilection sites of SCC,with more lesions located on sun-exposed areas than non-sun-exposed areas.Pathologically,there are more well to moderately differentiated SCCs than poorly differentiated.Our study is in accordance with the former theory indicating a role of sun exposure and HPV infection in the etiology of cutaneous SCC.