皮肤鳞状细胞癌临床和病理分析

Clinicopathological features of cutaneous squamous cell carcinoma

目的探讨皮肤鳞状细胞癌的临床和病理特点。方法收集2009--2012年经组织病理诊断为皮肤鳞状细胞癌的58例患者的临床及病理资料，对临床和组织病理学特征进行回顾分析。结果皮肤鳞状细胞癌高峰发病年龄为70～89岁，皮损见于头面部27例（46．55％），外生殖器部位20例（34．48％），四肢9例（15．52％），躯干2例（3．45％）。临床上表现为结节隆起型27例，占46．55％，深在浸润型19例，占32．76％，溃疡型12例，占20．69％。组织病理表现为经典型51例，特殊类型7例（疣状型5例、腺性鳞癌1例、透明细胞型1例）。结论皮肤鳞状细胞癌好发于老年人曝光部位，应及早进行组织病理学检查以明确诊断，提高患者生存率。

Objective To analyze clinicopathological features of cutaneous squamous cell carcinoma （CSCC）. Methods A retrospective study was performed on 58 patients diagnosed with CSCC in the Department of Pathology, Shanghai Skin Disease Hospital from 2009 to 2012. The clinicopathological data on these cases were analyzed. Results The peak age at onset of CSCC was 70 - 89 years. The most commonly affected sites were the scalp and face （27 cases, 46.55%）, followed by genitalia （20 cases, 34.48%）, limbs （9 cases, 15.52% ）, and trunk （2 cases, 3.45% ）. Of these cases, 27 （46.55%） were clinically identified as nodular and protrude type, 19 （32.76%） deeply infiltrating type, 12 （20.69%） ulcerative type. Pathologically, these cases were classified into classical type （n = 51 ） as well as non-classical type （n = 7）, and non-classical type included verrucous type （n = 5）, adenosquamous type （n = 1）, clear cell type （u = 1）. The agreement between clinical and pathological diagnosis was only 48.28%. Conclusions CSCC usually affects sun-exposed areas in the aged. Pathological examination should be carried out as early as possible to make a definitive diagnosis and to improve survival rate in patients.