11例皮肤瘢痕癌的诊疗体会  

A Report of Diagnosis and Treatment of 11 Cases of Skin Cicatric Cancer

作　　者：肖调立[1,2] 田道法[1] 刘刚[3] 

机构地区：[1]湖南中医药大学,长沙410007 [2]湖南省第二人民医院整形美容科 [3]湖南省第二人民医院耳鼻喉科

出　　处：《中国慢性病预防与控制》2011年第3期284-285,288,329,共4页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的总结11例皮肤瘢痕癌的诊疗经验。方法11例患者均行局部病灶组织活检确诊，然后予行扩大切除术联合皮瓣和（或）厚皮片移植修复，合并区域淋巴结肿大者加行区域淋巴结清扫术；因局部癌肿固定而怀疑癌细胞残存者，术后加行局部放射治疗。所有患者均行术后随访观察。结果本组病例至少表现4种临床类型，即溃疡型、菜花型、膨隆型和混合型。经术后0．5～17年随访观察，全部患者中有2例出现病变复发，其中1例经再度扩大切除术加皮瓣转移术治疗，术后随访0．5年无复发，另l例死于其他全身性合并疾病；其余10例均健在，功能和外观恢复满意。结论手术扩大切除加皮瓣和（或）皮片移植是瘢痕癌的首选有效治疗方法。本病重在预防，不稳定型瘢痕的治疗并防止瘢痕溃疡的发生，是预防瘢痕癌变的重要措施。Objective To Sum up the clinical experiences of the diagnose and treatment of 11 cases with skin cicatdc cancer. Methods 11 patients with skin eicatrie cancer were included aud diagnosed by local lesion biopsy before operation. Then, all these cases were undergone an enlarged excision operation on their focuses, combined with the repairing procedures of skin flaps and/or thick skin slips to restore the skin defection in the local area at the same time. When local lymph nodes enlarged, radical regional dissection was also performed. For those patients who were suspected residual cancer cells because of local fixed tumor, local radiation was given after operation. All these cases were followed up after the surgery. Results All these 11 cases were manifested as four clinical types, i.e. ulcerous, fungating, uplifting and mixed types. As seen at the end of followed up period lasted for 0.5 to 17 years after operation, 2 of cases were found recurred with their lesions, one still survival without focus recurring at the end of 0.5 year after the second successful operating therapy, but another one died of other companied systematic diseases, and the remaining 10 cases were survived heahhy, and the function and appearance of their surgical treated areas was in satisfactory. Conclusion Enlarged local excision operation is the firstly considered effective therapy for skin eicatric cancer when combined with the repairing procedures of skin flaps and/or thick skin slips to restore the skin defection in the local area at the same time. For this kind of lesion, the prevention is the most important, and the important measure is to cure unstable scar in order to avoid occurrence of eicatric ulcer.

关 键 词：瘢痕 皮肤肿瘤 临床分型 诊断 治疗 

分 类 号：R73[医药卫生—肿瘤]