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Squamous cell carcinoma: pain as a clue to increased tumour diameter, increased invasion depth, the grade of differentiation, acantholysis and perineural invasion.

鳞状细胞癌: 疼痛作为肿瘤直径增加、浸润深度增加、分化分级、棘层松解和神经周围浸润的线索。

  • 影响因子:1.09
  • DOI:10.1111/ced.14066
  • 作者列表:"Pyne JH","Myint E","Clark SP","Clifopoulos C","Fishburn P","Gorji M","Hou R
  • 发表时间:2020-03-01
Abstract

BACKGROUND:Pain may be associated with actinic keratosis (AK), intraepidermal carcinoma (IEC) and invasive squamous cell carcinoma (SCC), which may all display high-risk features. AIM:To examine variation in pain frequency associated with these three conditions, and assess their invasive SCC surface diameter, invasion depth, grade of differentiation, presence of acantholysis and perineural invasion (PNI). METHODS:Pain was prospectively recorded for consecutive cases of AK, IEC and SCC from three institutions in Australia during the period 2016-2018. RESULTS:Pain with palpation was recorded with 15.8% of AK (n = 30/190), 15.1% of IEC (n = 345/299) and 29.0% invasive SCC (n = 247/853). Pain without palpation was respectively 1.1% (2/190), 4.0% (12/299) and 6.7% (57/853). Invasive SCC with increased surface diameters and deeper invasion recorded increased pain frequency. Pain did not vary significantly by the grade of differentiation in males. In females, well-differentiated SCC recorded more pain (45.4%; n = 473) than poorly differentiated SCC (9.1%; n = 11). Acantholytic SCC recorded more pain 48.7% (n = 29) than nonacantholytic SCC 35.2% (n = 824). Three out of five cases of PNI recorded pain. Pain intensity was not recorded, which was a limitation. CONCLUSION:Pain presence increases from AK to invasive SCC. Pain was more frequent in invasive SCC with increased surface diameter, deeper invasion, acantholysis and PNI. Pain frequency did not vary between the grades of differentiation in males. In females, pain was less frequent in poorly differentiated than in well-differentiated SCC.

摘要

背景: 疼痛可能与光化性角化病 (AK) 、表皮内癌 (IEC) 和浸润性鳞状细胞癌 (SCC) 有关,它们都可能表现出高风险特征。 目的: 检查与这三种情况相关的疼痛频率变化,并评估其侵袭性SCC表面直径、浸润深度、分化程度、棘层松解症和神经周围浸润 (PNI) 的存在。 方法: 前瞻性记录 2016-2018 期间澳大利亚三家机构的AK、IEC和SCC连续病例的疼痛。 结果: 15.8% 的AK (n = 30/190) 、 15.1% 的IEC (n = 345/299) 和 29.0% 的侵袭性SCC (n = 247/853) 记录了触诊疼痛。无触诊疼痛分别为 1.1% (2/190) 、 4.0% (12/299) 和 6.7% (57/853)。表面直径增加和浸润较深的侵袭性SCC记录到疼痛频率增加。疼痛在男性中的分化程度没有明显变化。在女性中,高分化SCC比低分化SCC (45.4%; n = 11) 记录到更多的疼痛 (473; n = 9.1%)。棘皮溶解型SCC记录的疼痛 48.7% (n = 29) 多于非棘皮溶解型SCC 35.2% (n = 824)。5 例PNI中有 3 例记录疼痛。没有记录疼痛强度,这是一个限制。 结论: 从AK到侵袭性SCC,疼痛存在增加。疼痛在浸润性SCC中更常见,表面直径增加,浸润更深,棘层松解和PNI。疼痛频率在男性分化等级之间没有变化。在女性中,低分化的SCC疼痛频率低于高分化的SCC。

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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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