摘要
目的探讨艾滋病患者合并阴茎癌的临床诊断与治疗。方法收集作者2012年3月至2015年2月援助博茨瓦纳期间所诊治的艾滋病合并阴茎癌患者共24例,对其临床表现、诊断、手术治疗方案、术后疗效等影响因素进行分析总结。结果 24例患者平均年龄38.6岁。临床表现为局部肿块(11/24,45.8%)、溃疡(9/24,37.5%)及丘疹(4/24,16.7%)。发病时22例患者正接受HAART治疗,18例(75.0%)患者CD4水平较低(低于350/μL),存在明显的免疫抑制状态。病理类型为鳞状细胞癌22例,鳞癌合并卡波西肉瘤2例。22例患者进行手术治疗,2例T4期患者未手术治疗。2例阴茎鳞癌合并卡波西肉瘤,于发病后4个月和6个月得到确诊,并行阴茎全切加尿道会阴部造口术,术后恢复良好,未见肿瘤转移。结论卡波西肉瘤是艾滋病患者常见的皮肤病损,阴茎卡波西肉瘤容易掩盖阴茎鳞状细胞癌的症状,从而耽误阴茎癌诊断与治疗,需要引起足够的注意。
Objective To investigate the clinical diagnosis and treatment of penile cancer in AIDS patients. Methods A total of 24 AIDS patients with penile cancer admitted in the Nyangabgwe Hospital of Botswana from March 2012 to February 2015 were enrolled in this study. Their clinical manifestations,diagnosis,surgical treatment and outcomes,and the related influencing factors were analyzed. Results The patients were at a medium age of 38. 6,with the manifestations of penile masses（ 11 /24,45. 8%）,penile ulcer（ 9 /24,37. 5%） and penile papules（ 4 /24,16. 7%）. At the diagnosis of penile cancer,22 of them were given highly active antiretroviral therapy（ HAART）. Eighteen patients（ 75. 0%） had lower numbers of CD4＋T lymphocytes（ ≤350 cells / μL）,and in obvious immunosuppression. Biopsy and histopathological observation confirmed that all patients were squamous cell carcinoma（ SCC）,and 2 of them were combined with Kaposi＇s sarcoma（ KS）. Twenty-two patients received surgical treatment,and 2 cases at T4 underwent no such treatment. For the 2 cases combined with KS,they were diagnosed in 4 and 6 months respectively after onset,and were treated by radical penectomy and urethral perineal colostomy. They were recovered well after surgery,and no tumor metastasis was found after that. Conclusion Penile KS is the common skin lesion for those patients, which may delay the diagnosis of penile SCC because of similar clinical manifestation. So,special attention should be paid to penile KS.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第1期89-92,共4页
Journal of Third Military Medical University
关键词
HIV感染
艾滋病
阴茎癌
HIV infection
acquired immune deficiency syndrome
penile cancer
