Quaedvlieg P J F, Creytens D H K V, Epping G G, Peutz-Kootstra C J, Nieman F H M, Thissen M R T M, Krekels G A
Department of Dermatology, University Hospital Maastricht, Maastricht, the Netherlands.
Histopathology. 2006 Sep;49(3):256-64. doi: 10.1111/j.1365-2559.2006.02472.x.
The reported incidence of metastasis from squamous cell carcinoma (SCC) of the skin and lip varies between 0.5% and 16%. Clinical and histopathological criteria have been proposed to identify tumours that may have an increased risk of metastasis. The aim of this study was to define such high-risk tumours, especially since the incidence of SCC of the skin is increasing.
Histopathological features of metastasized skin and lip tumours and a matched group of non-metastasizing tumours were reassessed. Characteristics studied were: tumour width, excision margins, histological subtype, Clark level, Breslow depth, tumour differentiation, inflammation, perineural and angio-invasive growth, ulceration and desmoplasia. Data were statistically analysed separately for skin and labial lesions. Desmoplasia, Clark level, Breslow depth, maximum diameter, angio-invasion, grading, perineural invasion, plasma cells and eosinophilic inflammatory response proved to be statistically significantly related to metastasis of skin tumours. Breslow depth, plasma cells and grading appeared to be statistically significantly related to metastasis of SCC of the lips.
A typical metastatic SCC showed: a tumour width of at least 15 mm, a vertical tumour thickness (=Breslow) of at least 2 mm, less differentiation, presence of desmoplasia and an inflammatory response with eosinophils and plasma cells.
皮肤和唇部鳞状细胞癌（SCC）转移的报道发病率在0.5%至16%之间。已经提出了临床和组织病理学标准来识别可能具有更高转移风险的肿瘤。本研究的目的是确定此类高风险肿瘤，特别是鉴于皮肤SCC的发病率正在上升。
对转移的皮肤和唇部肿瘤以及一组匹配的非转移肿瘤的组织病理学特征进行了重新评估。研究的特征包括：肿瘤宽度、切除边缘、组织学亚型、克拉克分级、布雷斯洛深度、肿瘤分化、炎症、神经周围和血管浸润性生长、溃疡和促纤维增生。分别对皮肤和唇部病变的数据进行了统计分析。促纤维增生、克拉克分级、布雷斯洛深度、最大直径、血管浸润、分级、神经周围浸润、浆细胞和嗜酸性炎症反应被证明与皮肤肿瘤的转移在统计学上显著相关。布雷斯洛深度、浆细胞和分级似乎与唇部SCC的转移在统计学上显著相关。
典型的转移性SCC表现为：肿瘤宽度至少15毫米，肿瘤垂直厚度（=布雷斯洛）至少2毫米，分化程度较低，存在促纤维增生以及伴有嗜酸性粒细胞和浆细胞的炎症反应。
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