Lipkin A, Miller R H, Woodson G E
Laryngoscope. 1985 Jul;95(7 Pt 1):790-3.
Thirty-nine adults (34 male, 5 female) age 40 or under with squamous cell carcinoma of the head and neck (excluding nasopharyngeal carcinoma) were seen at the Baylor College of Medicine affiliated hospitals from 1964 to 1983. The average age of the patients was 36.3 years and they were nearly uniformly heavy smokers and drinkers. Twenty-six of the 39 patients were black. Lesions of the oral cavity and oropharynx were most frequent, followed by laryngeal lesions. Four patients presented with second primary tumors, and one patient had three separate lesions. Of the 39 patients, only 8 had cancers small enough to be considered curable by radiotherapy or organ-sparing surgery. The remainder of the patients required radical surgery (26), were considered incurable at the time of presentation (8), or refused treatment (3). Also noted was a relatively high incidence of prior trauma (gunshot wounds, laparotomies for trauma). Of 30 patients available for follow-up more than one year after treatment, 19 have died of their tumors. Only one patient had a documented immune disorder (systemic lupus). In contrast to previous authors, we conclude that the development of squamous cell carcinoma at a young age can be related to heavy smoking and drinking and that the poor survival in many patients is due to self-neglect and failure to seek medical care early in the course of the disease.
1964年至1983年期间，在贝勒医学院附属医院共诊治了39例40岁及以下的头颈部鳞状细胞癌（不包括鼻咽癌）成年患者，其中男性34例，女性5例。患者的平均年龄为36.3岁，几乎均为重度吸烟者和饮酒者。39例患者中有26例为黑人。口腔和口咽病变最为常见，其次是喉部病变。4例患者出现第二原发肿瘤，1例患者有3个独立病变。39例患者中，只有8例癌症病灶小到可通过放疗或保留器官手术治愈。其余患者需要进行根治性手术（26例），就诊时被认为无法治愈（8例），或拒绝治疗（3例）。还注意到既往创伤（枪伤、创伤剖腹手术）的发生率相对较高。在治疗后可随访一年以上的30例患者中，19例死于肿瘤。只有1例患者有记录在案的免疫紊乱（系统性红斑狼疮）。与既往作者不同，我们得出结论，年轻时发生鳞状细胞癌可能与重度吸烟和饮酒有关，许多患者生存不佳是由于自我忽视以及在疾病过程中未能尽早寻求医疗救治。
