摘要
目的 : 进一步了解麻风下肢溃疡癌变的流行病学情况、临床特征及其治疗预后 ,为溃疡恶变的预防、早期发现和合理治疗提供参考。方法 : 对 1980年 6月～ 2 0 0 1年 9月期间由全省各地转到我院作住院治疗且有完整病历的麻风下肢溃疡癌变病例作回顾性分析 ,并对治疗结果作进一步追踪观察。结果 : 共收治 2 1例 ,男 15例 ,女 6例 ;年龄 48～ 71岁 (平均 5 9.1岁 ) ;溃疡病程 8～ 3 0年 (平均16.2年 ) ;16例溃疡位于足底 ,4例位于小腿下部 ,1例位于踝部。病理分级 :1级 16例 ,2级 5例 ;1993年10月以前的病例全部作了大腿截肢 ,此后的病例全部作了小腿截肢。 3例失访 ;得到随访的 18例中 ,截止 2 0 0 1年 9月术后已平均存活 3 7.7个月 ;已有 9例死亡 ,大部分死于术后 1年左右。有 10例确定有肿瘤转移 ,2例在局部 ,4例腹股沟淋巴结转移 ,4例发生远处转移。结论 : 溃疡病期在 10年以上者是溃疡癌变的高发人群。
Objective:To determine the epidemiological status, clinical features and prognosis of squamous cell carcinoma arising from chronic lower leg ulcers in leprosy. Method:The data from twenty-one leprosy cases with squamous cell carcinoma arising from chronic lower leg ulcers were analyzed retrospectively. Results: From 1980 to 2001, 21 cases were diagnosed as squamous cell carcinoma and treated in the provincial leprosy hospital, including 15 males and 6 females, with average age of 59.1 years (48-71 yrs) and the mean ulcer duration of 16.2 years ( 8-30 yrs). Sixteen ulcers were located on soles, 4 on lower legs and 1 on ankle. Squamous cell carcinoma was the only neoplasia in this group with well to moderate tumor differentiation (grade 1-2). However, metastasis was common (10 cases) and resulted in a fatal outcome. Above-knee amputation was performed on all cases (10 cases) before September 1993, and in the remaining cases below-knee amputation was performed. By Sept 2001, 10 patients hadheen still alive, 9 died of metastasis and 3 lost follow-up. The postoperative survival time was 37.1 months on average. Conclusion : The patients with chronic foot ulcers for more than 10 years are at higher risk in development of cancer. Early diagnosis and treatment are the keys in reducing the death due to oncogenesis of chronic foot ulcers in leprosy.
出处
《中国麻风皮肤病杂志》
北大核心
2003年第1期19-21,共3页
China Journal of Leprosy and Skin Diseases
