外阴鳞状细胞癌109例临床分析

The clinical analysis of 109 cases of vulvar squamous cell carcinoma

目的 分析外阴鳞状细胞癌（简称：鳞癌）的临床资料,探讨外阴鳞癌发病的相关因素.法 回顾性分析109例外阴鳞癌患者的临床资料.结果 外阴鳞癌发病年龄多在50 ～ 69岁,病程多为6～12个月,好发于大阴唇,病灶大小2～4cm,90％以上为高分化鳞癌.按2009年外阴癌FIGO新分期重新划分结果,ⅠB期增多,Ⅱ、Ⅲ期下降.109例患者合并外阴上皮内非瘤样病变99例,白变主要累及大小阴唇,病理类型中外阴硬化性苔藓占60％（59/99）.多在病变的10～15年出现癌变.结论 外阴上皮内非瘤样病变与外阴鳞癌关系密切.长时间的病变有发生癌变的风险,定期复查可及早发现癌变.

Objective To analyze the clinical data of vulvar squamous cell carcinoma and discuss the related risk factors.Methods The clinical data obtained from 109 cases of vulvar squamous cell carcinoma were analyzed retrospectively.Results The most common ages of onset were 50-69 years.The course of canceration was usually 6-12 months,and most lesions occurred on the labia majora.The sizes of tumour were around 2-4 cm,and more than 90 % of lesions were well-differentiated squamous cell carcinomas.According to 2009 FIGO new staging of vulva cancer,more patients were reclassified as stage Ⅰ B,while patients with stage Ⅱ and Ⅲ became less.99 out of 109 patients also had nonneoplastic epithelial disorders of vulva.The lesions mostly affected the labia majora and the labia minora,and 60 % of them were pathologically diagnosed as lichen sclerosus.Patients with nonneoplastic epithelial disorders of vulva usually developed into vulvar carcinoma within 10-15 years.Conclusion The incidence of vulvar squamous cell carcinoma is closely related with vulvar nonneoplastic epithelial disorders of the vulva.As the chronic nonneoplastic epithelial disorders of vulva increase the risk of vulvar cancer,periodic follow-up will help its early detection.