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非黑素瘤性皮肤浅表恶性肿瘤及癌前病变是临床常见病,主要包括日光性角化病、基底细胞癌、鲍温病、乳房外Paget等。其病因复杂,多与紫外线照射、化学致癌物质、电离辐射等有关,确切原因尚难确定。目前,Mohs手术由于可完整彻底的切除肿瘤组织,同时最大限度减少皮肤缺损面积等优点,是治疗皮肤浅表恶性肿瘤(除日光性角化病)的首选方法。除此之外,其他治疗方法还包括光动力、放疗、化疗、冷冻、激光以及局部外用咪喹莫特或5-氟尿嘧啶等。然而,有些情况下,某种方法单独使用往往存在局限性,而综合治疗可以提高治愈率、减少不良反应,提高患者的满意度。综合治疗是系统的个体化的治疗,而不是几种治疗方法的固定叠加。本文将对非黑素瘤性皮肤浅表恶性肿瘤及癌前病变的综合治疗作一综述。
Non-melanoma superficial malignant tumors and precancerous lesions are common clinical diseases, including solar keratosis, basal cell carcinoma, Bowen’s disease, extramammary Paget and so on. The etiology is complex, and more with ultraviolet radiation, chemical carcinogens, ionizing radiation and so on, the exact reason is difficult to determine. Currently, Mohs surgery is the preferred method for the treatment of superficial malignant tumors of the skin (except for solar keratosis) due to the complete and complete removal of tumor tissue while minimizing the area of skin defects. In addition, other treatments include photodynamic therapy, radiotherapy, chemotherapy, freezing, laser and topical imiquimod or 5-fluorouracil. However, in some cases, there are often limitations to using a single method, and comprehensive treatment can improve the cure rate, reduce adverse reactions and improve patient satisfaction. Comprehensive treatment is a systematic, individualized treatment, not a fixed overlay of several therapies. This article will review the comprehensive treatment of non-melanoma superficial malignant tumors and precancerous lesions.