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下唇癌前病变与恶性肿瘤的手术治疗态度

Surgical attitude in premalignant lesions and malignant tumors of the lower lip.

作者信息

Calcaianu N, Popescu S A, Diveica D, Lascar I

机构信息

Clinic of Plastic Surgery and Reconstructive Microsurgery, Bucharest Clinical Emergency Hospital, Bucharest, Romania ; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Clinic of Plastic Surgery and Reconstructive Microsurgery, Bucharest Clinical Emergency Hospital, Bucharest, Romania.

出版信息

J Med Life. 2015 Jan-Mar;8(1):109-11.

Abstract

INTRODUCTION

Malignant tumors of the lower lip may have a variety of histopathology forms. The diagnosis and treatment of premalignant lesions are extremely important to avoid their malignant evolution. The lower lip tumor diagnosis is based on a series of correlations: anamnestic, clinical, laboratory and histopathological (the latter giving the certain diagnose).

MATERIAL AND METHODS

This study was carried out by selecting the cases with lower lip tumors operated between January 2012 and July 2014, in the Plastic Surgery and Reconstructive Microsurgery Clinic of Bucharest Clinical Emergency Hospital. The variables considered in the study were the following: age, gender, exposure to risk factors, diagnosis, and histopathology.

RESULTS

The histopathological examination revealed 63% squamous cell carcinoma, 30% basal cell carcinomas, 5% keratoacanthoma and 2% actinic keratosis. Men were the predominantly affected genre, with a percentage of 70%. In the group of patients studied, 66% were smokers.

DISCUSSIONS

The rate of the malignant transformation of premalignant lesion was 32.6% for keratoacanthoma, 16.9% for actinic cheilitis, 10% for actinic keratoses.

CONCLUSIONS

There were no clinical or laboratory features to plead for the pre-malignant or malignant character of the of a lower lip tumor, consequently histopathological examination was used for the diagnosis of the lesion. Due to the high percentage of malignant transformation of precancerous lesions, particularly in the form of squamous cell carcinoma, the surgical attitude intending to eradicate a lower lip tumor from an oncological point of view was the excision with oncologic safety margins followed by a lip reconstruction.

摘要

引言

下唇恶性肿瘤可能有多种组织病理学形式。癌前病变的诊断和治疗对于避免其恶性演变极为重要。下唇肿瘤的诊断基于一系列关联因素:病史、临床、实验室及组织病理学检查(后者给出明确诊断)。

材料与方法

本研究选取了2012年1月至2014年7月在布加勒斯特临床急救医院整形与重建显微外科门诊接受手术的下唇肿瘤病例。研究中考虑的变量如下:年龄、性别、危险因素暴露情况、诊断及组织病理学。

结果

组织病理学检查显示,鳞状细胞癌占63%,基底细胞癌占30%,角化棘皮瘤占5%,光化性角化病占2%。男性为主要受累性别,占比70%。在研究的患者组中,66%为吸烟者。

讨论

角化棘皮瘤的癌前病变恶性转化率为32.6%,光化性唇炎为16.9%,光化性角化病为10%。

结论

没有临床或实验室特征能够支持下唇肿瘤的癌前或恶性特征,因此组织病理学检查用于病变的诊断。由于癌前病变的恶性转化率较高,特别是鳞状细胞癌形式,从肿瘤学角度旨在根除下唇肿瘤的手术方式是进行具有肿瘤学安全切缘的切除,随后进行唇部重建。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66d8/4397509/177d47985423/JMedLife-08-109-g001.jpg

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