阴茎疣状癌的诊治并文献复习

目的:探讨阴茎疣状癌的诊疗方法。方法:收治阴茎疣状癌患者5例,回顾性分析临床资料,结合文献复习进行讨论其病因、病理特点、诊断和治疗。结果:所有患者均未行腹股沟淋巴结清扫及放化疗,5例患者病理显示肿瘤分化好,标本切缘均呈阴性。标本切片均显示上皮呈角化过度,呈乳头瘤样结构,基底部和周边部均呈球茎状推进式生长。周围间质中可见大量淋巴细胞浸润。术后随访0.6～5年,平均3.4年,无肿瘤复发或转移。行局部肿瘤切除术者,术后性生活较满意。结论:阴茎疣状癌细胞分化好,以局部侵袭性生长为主,很少发生区域淋巴结或远处转移。采取肿瘤局部切除或阴茎部分切除术治疗阴茎疣状癌,患者预后好。当该病可能与HPV感染密切有关时,单纯手术治疗肿瘤容易复发,有必要进行针对性治疗并行长期随访。

Objective ：To explore the diagnosis and treatment of penile verrucous carcino ma. Methods： The clinical and pathological data of 5 patients with penile verrucous car cinoma were analyzed with literature review to discuss its etiology and pathology, charac teristics, diagnosis and treatment from Janu ary 2007 to January 2012. Results ： None of 5 patients received ilioinguinal lymphade nectomy. Histopathological examination of the specimens showed that the tumor cells were mostly well differentiated and the surgical margins were tumor free in all the 5 cases. HE stain was performed in all the specimens. Microscopic examination re vealed papillomatosis and hyperkeratosis of the epithelium,with bulbous projections intothe lamina propria consisting of well dif ferentiated squamous epithelial cells. Marked invasion of the stroma by lympho cytes was noted. Follow up ranged from 0. 6 to 5 years （ average 3.4 ）, revealing no re currence. The patients with local excision of the tumors reported satisfaction of their sex ual lives. Conclusions ： Verrucous carcinoma of the penis is a well differential disease with low malignant potential and locally ag gressive nature. It seldom develops metasta sis to regional lymphonodes or distant areas. Glansectomy or partial penectomy can be chosen for its treatment, with favorable prog nosis. When the disease could closely relat ed with HPV infection, tumor recur easily by pure surgical treatment, so it is necessary to do the specific therapy and long term fol low up.