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目的探讨皮肤侵袭性鳞状细胞癌(SSCC)的临床表现及组织病理特征的相关性。方法回顾性分析84例临床及组织病理资料齐全的侵袭性SSCC患者的临床资料,以30例正常皮肤组织为对照组,分析其临床表现及组织病理类型特征。结果 84例患者中,病灶为溃疡型20例(23.8%)、结节隆起型46例(54.8%)、浸润型16例(19.0%)、萎缩型2例(2.4%);暴露部位为头面部51例(60.7%)、会阴部20例(23.8%)、躯干部13例(15.5%)。组织病理类型中寻常型52例(61.9%)、疣状型14例(16.7%)、基底细胞样型12例(14.3%)、尖锐湿疣型6例(7.1%);病灶周边区域表皮病变中轻度上皮内瘤变31例(36.9%)、鳞状上皮增生27例(32.1%)、中重度上皮内瘤变26例(31.0%)。与对照组相比,SSCC患者病灶组织p16蛋白阳性表达较低,而pRb蛋白表达较高(P<0.05)。结论 SSCC临床上以头面部及结节隆起型最常见,组织病理类型以寻常型常见,应用免疫组织化学技术有助于诊断。
Objective To investigate the correlation between clinical manifestations and histopathological features of skin invasive squamous cell carcinoma (SSCC). Methods The clinical data of 84 patients with clinically and histopathologically informative SSCC were retrospectively analyzed. The clinical features and histopathological features of 30 patients with normal skin tissue were analyzed. Results Of the 84 patients, the lesions were ulcerative in 20 cases (23.8%), nodular bulging in 46 cases (54.8%), infiltration in 16 cases (19.0%) and atrophy in 2 cases (2.4%). 51 cases of facial (60.7%), 20 cases of perineal (23.8%), 13 cases of trunk (15.5%). There were 52 cases (61.9%) of vulgaris, 14 cases (16.7%) of verrucous, 12 cases of basal cell (14.3%) and 6 cases of condyloma acuminatum (7.1%). There were 31 cases (36.9%) with mild intraepithelial neoplasia, 27 cases (32.1%) with squamous cell hyperplasia and 26 cases (31.0%) with moderate and severe intraepithelial neoplasia. Compared with the control group, the positive expression of p16 protein and the expression of pRb protein in SSCC patients were lower (P <0.05). Conclusion The clinical manifestations of SSCC are the most common type of head and face nodules, and the histopathological types are common. The application of immunohistochemistry is helpful for the diagnosis.