Clinic And Pathology Analysis Of 74 Patients With Squamous Cell Carcinoma

Squamous cell carcinoma is one of the most frequent malignant skin tumor, which main occur in the exposed part of body, include the scalp, face, neck and the back of the hand, often grow with primarily rash, It has the highest incidence in the elderly. It has upward trend of the world. It's incidence is the second which lower than BCC among the non-melanoma skin cancer in the United States and other white-dominated areas, contrally the most frequent malignant skin tumor.It's etiological factors and etiopathogenisis are complicated. A lot of researches indicated that it's incidence maybe related to ultraviolet, human papilloma virus infections, chemical carcinogenesis material, cancer gene mutations, precancerous lesions and other dermatosis and so on. The main reason is the exposure under the ultraviolet. SCC is easy to transfer, and have invasion. It can destruct the texture and the structure to lead to functional obstacles of organs, and even death of serious patients. It's very necessary to enhance doctors'reconstruction and have a early diagnosis even treatment. The clinical types of SCC are variegated, often grow with other rashes, which leads to high rate of misdiagnosis. So it's very important for choosing more appropriate treaments under the histopathologic diagnosis. The treatments of SCC are varied, operation always be conceived the first treatment.Now with more and more unceasing deep investments, many new treatments had extensive clinical application, such as gene therapy increasingly been highlighted in research fields. Early prevention is also critical without energetic treatments. Meanwhile to hance people's comprehansion of SCC, improve vigilance and made some preventions, thereby have early discovery and early treatment can reduce the incidence of disease and mortality.SCC has a better prognosis, but often has metastasis. Because of occuring with other rashes, it has not been sufficient attention by the public and clinician, but it has induce remarkable hazard of public health. To improve the standards of diagnosis, precaution and treatment for reducing the incidence of disease and mortality, a retrospective review had been conducted from 1988 to 2006, 74 cases SCC with exlicit pathologic diagnosis of dept. of dermatology in our hospital are analysed. A integrated analysis about the clinical, pathology, diagnostic charateristics, its causes, prevertion and treatment have been done. According to the clinical criteria divided into nodul type, ulcer type and infiltrate type. Pathological types include ordinary type and unusual type. According to Broders'criteria for the classifiation of ordinary type of SCC, pathological types are divided into four types includingⅠtype,Ⅱtype,Ⅲtype andⅣtype; and the unusual type also have four types: verrucous type, adenoid type, fusiform cells type, clear cell type. 46 cases are male, 28 cases are female of 74 patients, the proportion of men andwomen is 1.64:1. Age of onset from 7 years old to 90 years old, with an average of 56.77±20.12 years. 62(83.78%) cases are 40 and above 40 years of age, 12(16.22%) persons whose age under 40 years. Course of disease from 2 weeks to 40 years, with an average of 3.06±6.98 years. There are 47 cases of peasants, 16 cases of workers and 11 cases of other occupations. Incidence parts: there are 31 cases take place on first face, 1 case on neck, 7 cases on trunk, 17 cases on limbs and 18 cases on genitals. The largest area of skin lesion is 10×10cm2, the smallest diameter is 0.5cm of 74 cases. 67(90.54%) cases of tumors are single, 37(50%) cases take place ulcers with the tumor, and 73(98.65%) cases are clear lines of 74 cases. The most common clinical types are nodul type and ulcer type, respectively 49 cases(66.22%) and 21 cases (28.38%). Pathological common type with 50 cases (67.57%) up to see, followed by adenoid with 9 cases (12.16%). The clinical diagnosis rate is 89.19%, and clinical misdiagnosis rate of 10.81%.χ2-test for statistical processing.The results of the study are:1. 74 cases of SCC patients, there are significant difference between age of onset and male-female constitute ratio (P<0.05), males are more than females, 40 years and older patients are particularly prevalent.2. The first face is the most common which occur in exposed parts, and the differences are very significant about different ages and different occupations, among 74 cases with SCC, 40 years andolders are more common (P<0.01); farmers are up to see(P<0.01).3. The tumors which take place ulcer in the central between men and women (P>0.05) and about different age (P>0.05) have no significant differences; the tumors in clinical criteria, gender and age have no significant differences (P>0.05); there are significant differences between different occupations in the location of the tumors take place (P<0.01), and the first face is the most common which occur in exposed parts (P<0.01).4. There are no significant differences between incidence of age male-female constitute ratio in defferent pathological types (P>0.05); in different pathological types, verrucous type is more common in generative organs (P<0.01), and other types is common in first face (P<0.01). The tumors which take place with ulcer is common inⅠtype (P<0.01) and often take place in the first face (P<0.01).5. The nodul type of clinical types most vulnerabe to misdiagnosis (P<0.05).We can draw some conclusion from our study, as follow:1. Chroniclly long-term solar exposure associated with the occurrence of SCC.2. Subdivisions of histopathology are crucial about diagnosis, treatment and judgment of prognosis of SCC.3. To understand the invasive and destructive of SCC impact to the human health for improving the degree of reconstruction of clinician.4. Timely and reasonable treatment is important factor to reduce the recurrence of SCC.5. Raising public awareness of health education is key to reduce morbidity and mortality of SCC.