Grauwin M Y, Gentile B, Chevallard A, Cartel J L
Institut de Léprologie Appliquée, Dakar, Sénégal.
Acta Leprol. 1994;9(1):25-30.
Between 1988 and 1992, 21 biopsies for pathological examination were taken from 20 Senegalese leprosy patients suffering from chronic plantar ulcers (CPU) suspected of malignant transformation. The diagnosis of squamous cell carcinoma was effectively made in 13 cases and that of pseudoepitheliomatous hyperplasia in the remaining 8 cases. The mean period of time between the onset of CPU and that of malignant transformation was 10 years (range: 1 to 15 years); the mean annual frequency of the malignant transformation was 2 per 1,000 CPU. In countries where pathological examination is not available, below knee amputation could be considered whenever main clinical signs of malignant transformation are present. In countries where pathological examination is available, the therapeutic decision may differ according to the diagnosis: below knee amputation supplemented with block dissection of inguinal lymph nodes whenever possible in cases of carcinoma; below knee amputation depending on the function status of the foot and on the volume of tumor in case of pseudo-epitheliomatous hyperplasia.
1988年至1992年间，对20名患有疑似恶变慢性足底溃疡（CPU）的塞内加尔麻风病患者进行了21次病理检查活检。其中13例确诊为鳞状细胞癌，其余8例为假上皮瘤样增生。CPU发病至恶变的平均时间为10年（范围：1至15年）；恶变的年均发生率为每1000例CPU中有2例。在无法进行病理检查的国家，只要出现恶变的主要临床体征，可考虑进行膝下截肢。在可进行病理检查的国家，治疗决策可能因诊断而异：对于癌症患者，尽可能在膝下截肢并辅以腹股沟淋巴结整块清扫；对于假上皮瘤样增生患者，根据足部功能状态和肿瘤大小决定是否进行膝下截肢。
