皮肤转移癌62例临床特征分析

Clinical analysis of 62 cases of cutaneous metastases from internal cancers

目的探讨皮肤转移癌的临床特征,加深对皮肤转移癌的认识。方法回顾性分析首都医科大学附属北京友谊医院2002年1月至2015年12月诊治的62例皮肤转移癌患者的临床表现、形态特征、肿瘤来源和发生时间。结果 62例患者中男性40例,女性22例;发病中位年龄为60.0岁（33~82岁）。皮肤转移癌可发生在腹部、胸背部、头皮、四肢等全身皮肤的各个位置,其中以腹壁转移最为多见。原发癌病种最常见于肺癌、胃癌和结直肠癌。病理活检结果显示,40例与原发灶的病理学类型完全相符,3例与原发灶的形态学相符,但肿瘤分化程度不同。1例通过皮肤活检证实为第二原发癌合并皮肤转移癌的诊断。17例在原发癌确诊同时发现皮肤转移,大部分患者在原发癌确诊4年内出现皮肤转移。结论近年来随着肿瘤发病率的升高,皮肤转移癌亦随之增多,提高对皮肤转移癌的认识,有助于及早明确诊断和治疗,延长患者生存期。

Objective To analyze the clinical characteristics of cutaneous metastases from internal cancers,and enhance the understanding of cutaneous metastases. Methods In the retrospective study,the clinical features,primary sites of cancers,morphological features and occurence of 62 cases of cutaneous metastases from internal cancers diagnosed in Beijing Friendship Hospital from January 2002 to December 2015 were analyzed. Results There were 40 males and 22 females among the 62 patients. The median age at the onset of skin lesions was 60. 0 years（ range 33-82 years）. Cutaneous metastases occurred at various locations of the body,including abdomen,chest,back,scalp,limbs and etc. Abdominal wall was the most common site of cutaneous metastases,accounting for72. 6% of patients with cutaneous metastases. The most common types of primary cancer were lung cancer,gastric cancer and colorectal cancer. Pathological biopsy showed that 40 cases were in complete agreement with the pathologic types of the primary lesions,and3 cases were consistent with the morphology of the primary tumors,but the degree of tumor differentiation was different. One case was confirmed with second primary cancer by skin biopsy. Seventeen patients were comfirmed with cutaneous metastases when the primary cancers were diagnosed. Most patients were diagnosed with cutaneous metastases within 4 years after the primary cancers were comfirmed. Conclusion With increasing incidence of cancers,cutaneous metastases from internal cancers increased in recent years. Raising awareness of cutaneous metastases is helpful for early diagnosis,treatment and prolonging patients＇ life.