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目的总结归纳头面部鳞状细胞癌的临床特点,探讨其预后和防治原则。方法回顾性分析自2012年8月至2016年2月经组织病理确诊为头面部鳞状细胞癌患者的临床资料。结果本组患者共65例,年龄>50岁者58例(89.2%);头部28例,面部37例;原发病为皮肤良陛肿瘤者36例,溃疡者24例,皮肤缺损者5例;自原发病发展为癌的潜伏期为3~40年,平均为(16.2±5.6)年;发生局部淋巴结转移者10例,合并颅内及肺转移者各1例;55例未发生转移者均行手术根治性切除,8例发生局部淋巴结转移但无远处转移者均行手术根治性切除+局部淋巴结清扫,1例侵犯颅内及1例转移至肺者仅行创面处理及局部放疗;术后组织病理确诊为高分化鳞状细胞癌者58例,中、低分化鳞状细胞癌者7例;预后良好者57例,复发者8例。结论鳞状细胞癌潜伏期较长,及时处理原发病是预防鳞状细胞癌的重要措施;根治性手术切除是治疗头面部鳞状细胞癌的首选方法,术后预后良好。
Objective To summarize the clinical features of craniofacial squamous cell carcinoma and explore the principles of its prognosis and prevention. Methods The clinical data of patients diagnosed with head and face squamous cell carcinoma by histopathology from August 2012 to February 2016 were retrospectively analyzed. RESULTS: A total of 65 patients were included in this study. 58 patients (89.2%) were older than 50 years of age; 28 were in the head and 37 in the face; the primary disease was 36 patients with benign cutaneous tumors, 24 patients with ulcers, and 5 patients with skin defects. Cases; The incubation period from the original disease to cancer was 3 to 40 years, with an average of (16.2 ± 5.6) years; 10 cases of regional lymph node metastasis, 1 case with intracranial and lung metastases, and 55 cases without metastasis All patients underwent radical surgical resection. 8 cases of regional lymph node metastasis but no distant metastasis were performed radical resection surgery + regional lymph node dissection, 1 case of intracranial invasion and 1 case of metastasis to the lung only wound treatment and local radiotherapy Postoperative histopathology confirmed 58 cases of well-differentiated squamous cell carcinoma, 7 cases of moderately-differentiated squamous cell carcinoma, 57 cases of good prognosis, and 8 cases of recurrence. Conclusion The latencies of squamous cell carcinoma have a long incubation period. Prompt treatment of primary disease is an important measure to prevent squamous cell carcinoma. Radical surgical resection is the preferred method for the treatment of head and facial squamous cell carcinoma. The prognosis is good.