光线性角化病159例与皮肤鳞状细胞癌51例临床病理特征分析  

Clinical and Pathological Features of 159 Cases of Actinic Keratosis and 51 Cases of Squamous Cell Carcinoma

作　　者：牛蕊仙 丁冬梅 郑江涛 匡卫安 尹逊国[1] NIU Ruixian;DING Dongmei;ZHENG Jiangtao;KUANG Wei'an;YIN Xunguo(Department of Dermatology,Qujing First People's Hospital,Qujing 655000,China)

机构地区：[1]云南省曲靖市第一人民医院皮肤科,云南曲靖655000

出　　处：《中国皮肤性病学杂志》2020年第5期550-554,共5页The Chinese Journal of Dermatovenereology

摘　　要：目的了解滇东地区光线性角化病与鳞状细胞癌的疾病构成比、一般情况和临床病理特征。方法采用回顾性研究方法对曲靖市第一人民医院皮肤科2014年1月-2018年12月共5年行病理检查确诊的光线性角化病和皮肤鳞状细胞癌患者的临床和病理检查资料进行分析。结果159例光线性角化病(AK)与51例(SCC)鳞状细胞癌患者中女性多于男性,光线性角化病和鳞状细胞癌的发病平均年龄分别为(66.32±14.63)岁和(65.00±16.26)岁。光线性角化病和鳞状细胞癌患者皮损发生于曝光部位的分别占98.11%和78.43%。51例鳞状细胞癌患者中,有3例均是光线性角化病继发鳞状细胞癌,均为女性,年龄均>70岁,发病部位均为曝光部位。5年确诊光线性角化病患者占总病检患者的构成比相对稳定,其中鳞状细胞癌有所波动。AK病理分型分为肥厚型98例(61.64%)、萎缩型26例(16.35%)、棘层松解型12例(7.55%)、色素型9例(5.66%)、苔藓样型9例(5.66%)、鲍温样型5例(3.14%);SCC病理分级Ⅰ级39例(76.47%)、Ⅱ级11例(21.57%)、Ⅲ级1例(1.96%)、Ⅳ级0例。光线性角化病与鳞状细胞癌中临床诊断与病理诊断符合率分别为61.00%和56.86%,易被误诊为其他疾病。结论滇东地区光线性角化病与鳞状细胞癌以中老年女性为主,主要位于头面颈部等曝光部位,与紫外线关系密切,其中发生于曝光部位、皮损多样、病程长的老年女性光线性角化病患者易继发鳞状细胞癌,但临床病理诊断符合率较低,需引起重视。Objective The current study aimed to understand the diseases incidence,patients’general condition,and clinical and pathological features of actinic keratosis(AK)and squamous cell carcinoma(SCC).Methods The current study retrospectively analyzed clinical and pathological data of patients with AK and SCC confirmed by pathological examination in the department of dermatology,Qujing First People’s Hospital,from January 2014 to December 2018.Results There were more female patients than male patients among the 159 cases of actinic keratosis and 51 cases of squamous cell carcinoma.The mean age of patients with actinic keratosis was 66.32±14.63 years and with the squamous cell carcinoma was 65.00±16.26 years.The lesions of 98.11%cases of actinic keratosis and 78.43%of squamous cell carcinoma,occurred at exposed parts of the skin.Among the 51 patients with squamous cell carcinoma,there were 3 women over 70 years of age,with exposed lesions.The incidence of actinic keratosis diagnosed in 5 years was relatively stable,and of squamous cell carcinoma fluctuated.AK was classified into six histopathology types:hypertrophic-98 cases(61.64%),atrophic-26 cases(16.35%),acantholytic-12 cases(7.55%),pigmented-9 cases(5.66%),lichenoid-9 cases(5.66%)bowenoid-5 cases(3.14%).There were four histopathological grades of SCC:Ⅰgrade 39 cases(76.4%),Ⅱgrade 11 cases(21.57%),Ⅲgrade 1 case(1.96%),Ⅳgrade 0 cases(-).The consistency between clinical diagnosis and pathological diagnosis of actinic keratosis、squamous cell carcinoma was 61.00%and 56.86%,respectively.AK and SCC were easily misdiagnosed as other diseases.Conclusion The actinic keratosis and squamous cell carcinoma in the eastern Yunnan province region mainly occur in women over the age of 60.The lesions were mainly located on the exposed body parts,such as head,face and neck,that may result from exposure to ultraviolet rays.The elderly women with actinic keratosis at the exposed sites,skin damage,and long disease duration are prone to develop squamous cell carcinoma.Howe

关 键 词：光线性角化病 鳞状细胞癌 癌前病变 临床特征 组织病理特征 

分 类 号：R758.14[医药卫生—皮肤病学与性病学] R739.5[医药卫生—临床医学]