皮肤汗腺癌临床诊治分析

Clinical analysis on diagnosis and treatment of Sweat gland carcinoma of the skin

背景与目的:皮肤汗腺癌是一种临床少见的皮肤恶性肿瘤,有关报道有限,大部分属个例报道,由于病例数均较少,其诊断、治疗及预后等还存在一定的分歧,本文通过分析皮肤汗腺癌临床特点、治疗效果、生存情况和预后因素,旨在探讨其治疗方法及预后的影响因素等。方法:对2001年2月—2012年5月期间浙江省肿瘤医院收治的33例皮肤汗腺癌病例进行回顾性分析,对其临床表现、淋巴结转移、治疗情况及生存率等进行分析。结果:皮肤汗腺癌5年总生存率为70.0%,无复发生存率为57.0%,原发肿瘤高分化组与低分化组的生存率分别为78.9%和69.2%,差异有统计学意义(P=0.028)。在13例行淋巴结清扫的患者中淋巴结转移率为69.2%。结论:皮肤汗腺癌是一种淋巴结转移率高、术后易复发的恶性肿瘤,以手术治疗为首选,手术应充分考虑切除的广泛性,放化疗疗效需进一步研究。

Background and purpose： Sweat gland carcinoma of the skin is a rare malignant neoplasm. There are some differences in diagnosis, treatment and prognosis because of its rarity. The aim of this study was to evaluate treament and prognostic factors of sweat gland carcinoma of the skin. Methods： The clinical manifestation, treament, survival rate, prognosis of 33 cases of sweat gland carcinoma of the skin were reviewed. All patients were treated in Zhengjiang Cancer Hospital from Feb. 2000 to May 2012. Results： The 5-year overall survival （OS） and relapse free survival （RFS） were 70.0%, 57.0%, respectively. Patients with high differentiated primary tumor had OS of 78.9% vs 69.2% in patients with low differentiatiated entity. The lymph node metastasis was 69.2% in 13 cases who had accepted lymphadenectomy. Conclusion： Sweat gland carcinoma of the skin had high rates of local recurrence and a propensity for lymph nodal metastases. Operation is the first choice of treatment, Extensiveness resection should be fully considered during operation. Chemotherapy and radiotherapy efficacy remain unclear.