老年人皮肤肿瘤临床特征研究

The study of clinical features about skin neoplasms of the aged

目的研究老年人皮肤肿瘤的临床特点、性质、病理分型特征等,提高临床医师对老年皮肤肿瘤的认知及早期诊治水平。方法分析南京军区南京总医院年龄≥60岁,经组织病理明确为皮肤肿瘤患者1115例的临床、病理、治疗及预后等临床资料。结果老年人皮肤肿瘤病程普遍长,平均(14.2±8.6)年;分布广,全身均可发病,但头面部最多见(372例,占33.36%);合并皮损变化(43.59%)及自觉症状(33.63%)也是老年人主要就诊原因。病理类型多,来源于上皮细胞最多,且恶性程度普遍低;诊断符合率(42.69%)不高,临床将脂溢性角化病误诊为基底细胞癌、鳞状细胞癌及恶性黑色素瘤的比例(30.67%)最高,其次是将色素痣误诊为恶性黑色素瘤(17.21%)。结论老年人皮肤肿瘤病理学类型较多,诊断符合率不高。组织病理是诊断皮肤肿瘤的依据,手术切除是治愈率最高的方法。

Objective To Study clinical characteristics,property and pathological features of skin neoplasms among the aged, to improve the level of recognision and diagnosis of this disease in clinician. Methods Analyzing clinical and pathological data of 1115 cases ,whose diagnosis were proved by biopsy tissue pathology undered skin neoplasms in our hospital. The patients were all over 60 years old. Results The course of skin neoplasms among the aged was long, （ 14_＋8.6）years in average. The distribution of skin lesion was wide. All over the body could be involved. The most commonly seen was on the head ,with the number of it was 372 cases （33.36%）.. Main reason for consulting doctor were combining skin lesions （43.59%）and subjective symptom （33.63%）. The pathological types were various ,the most of it was originated from epithelium. The malignancy of it was low. The rate of diagnose was 42.69%. not high. Clinically often mis-diagnosed seborrheic keratosis as basal cell carcinoma,epidermoid carcinoma or malignant melanoma,accounted 30.67% of the mis-diagnosis. Ratio of mis-Diagnosing pigmented nevus to malignant melanoma was 17.21%. Conclusions The pathological types of the advanced＇s skin neoplasms were various and the diagnose rate was low. Diagnosis of skin neoplasms was based on tissue pathology. The method with highest recovery rate was lesion excision.