头皮非黑素瘤性皮肤癌59例临床分析

Retrospective Analysis of Clinical Characteristics of 59 Cases of Nonmelanoma Skin Cancers of the Scalp

目的了解头皮非黑素瘤性皮肤癌（nonmelanoma skin cancers，NMSC）患者的临床特征。方法回顾性分析本院1999年8月-2014年12月来自江西农村地区的头皮NMSC住院患者的临床和组织病理资料。结果共入选头皮NMSC共59例，其中男43例，女16例，男女比例为2．7：1；平均发病年龄68．0±11．8岁；皮肤鳞状细胞癌（squamous cell carcinoma，SCC）49例（83．05％），基底细胞癌（basal cell carcinoma，BCC）10例（16．95％）；病程2个月～10年，平均59．7±85．0个月；农民48例（81．36％），老年患者（≥60岁）48例（81．36％），既往有头癣病史并遗留陈旧性瘢痕和脱发20例（33．90％），其他原因致瘢痕7例（11．86％）；在SCC患者中，有局部或远处转移8例（13．56％）。在BCC中，10例均为结节溃疡型。结论老年男性是头皮NMSC的好发人群，以SCC多见，就诊较迟，转移率较高，瘢痕和脱发可能是其发病的一个重要诱因。

Objective To study the clinical characteristics of nonmelanoma skin cancers （NMSC） of the scalp. Methods A retrospective analysis of the clinical and pathological data was performed on the hospitalized patients administered in our hospital during 1999 - 2014 who suffered from NMSC of the scalp and lived in the rural areas of Jiangxi Province. Results A total 59 cases of NMSC were collected, including 43 males and 16 females （68.0± 11.8 years old, male to female ratio 2.7：1 ）, 49 （83.05%） cases of squamous cell carcinoma, 10 （ 16.95% ） of basal cell carcinoma, 48 （81.36%） of farmers, 48 （81.36%） of elderly patients （ ≥60 years）, 20 （33.90%） with scar and alopecia due to previous history of tinea capitis, 7 （11.86%） scars caused by other reasons, and 8 （13.56%） local or distant metastases. The shortest duration from onset to diagnosis was 2 months, the longest 10 years （59.7± 85.0 months）. In BCC, 10 cases were nodular ulcer type. Conclusions Patients with NMSC of the scalp in rural areas of Jiangxi province were mostly older men, more common with squamous cell carcinoma. A history of scar and alopecia may be a predisposing factor. Delayed diagnosis might result in with high metastasis rate.