人乳头瘤病毒16、18感染与阴茎癌、阴茎乳头瘤的关系

人乳头瘤病毒 (HPV)感染与外生殖器癌的发生密切相关 ,近年来HPV感染呈明显上升趋势。我们用PCR技术检测了 4 8例石蜡包埋的阴茎癌、阴茎乳头状瘤组织中HPV 16、HPV 182种亚型DNA的存在情况 ,探讨HPV感染与阴茎癌之间的关系 ,现将结果报告如下。1　材料与方法1 1　材料1 1 1　标本　收集武汉大学中南医院泌尿外科1980～ 1997年手术切除的 4 8例临床诊断为阴茎癌的石蜡标本 ,病理诊断为阴茎鳞状细胞癌 31例 ,阴茎乳头状癌 2例 ,阴茎乳头状瘤 15例。年龄 2 2～ 70岁 ,平均 4 8岁。1 1 2　试剂　HPV 16、HPV 18PCR诊断试剂盒购自厦…     

阴茎癌组织中人乳头瘤病毒DNA的原位杂交研究

为了研究人乳头瘤病毒与阴茎癌的关系，应用地高辛标记的ＨＰＶ６、ＨＰＶ１１、ＨＰＶ１６和ＨＰＶ１８ＤＮＡ探针分别对４６例阴茎癌组织进行原位杂交检测ＨＰＶＤＮＡ。结果显示：ＨＰＶＤＮＡ阳性２２例，其中ＨＰＶ１６ＤＮＡ阳性２０例，ＨＰＶ１８ＤＮＡ阳性４例，在２例转移癌和癌旁不典型增生组织中检测到了ＨＰＶ１６ＮＤＡ，未见ＨＰＶ６ＤＮＡ和ＨＰＶ１１ＤＮＡ阳性，ＨＰＶＤＮＡ位于癌细胞核中。结果表明原位杂交可以用来研究阴茎癌组织中ＨＰＶ的存在及分型，同时也证实了阴茎癌的发生和ＨＰＶ１６及ＨＰＶ１８感染有密切关系     

阴茎鳞状细胞癌预后因素的分析

目的:探讨影响阴茎鳞状细胞癌(penile squamous cell carcinoma, PSCC)预后的因素,并对影响PSCC患者预后的危险因素进行分析。方法:回顾性分析106例确诊为PSCC患者的临床资料,去找出影响预后的因素。考虑的因素包括T分期、组织学分级、浸润深度、淋巴管/血管的浸润、阴茎海绵体的浸润、尿道海绵体的浸润、尿道的浸润和腹股沟淋巴结转移。运用Kaplan-Meier法初步筛选出预后因素,再运用Cox回归模型进行多因素分析这些筛选出的预后因素与预后的关系。结果:101例获随访,随访率95.3%,随访8～86个月,中位随访53个月,死亡39例,其中死于肿瘤32例。Kaplan-Meier单因素生存分析T分期(P0.05)、组织学分级(P=0.006)、肿瘤浸润深度(P=0.005)、肿瘤浸润淋巴管/血管(P0.05)、肿瘤浸润尿道海绵体(P0.05)、肿瘤浸润尿道(P0.05)、腹股沟淋巴结转移(P0.05)与PSCC预后密切相关;Cox多因素生存分析只有组织学分级(P=0.009)、肿瘤浸润淋巴管/血管(P=0.006)、腹股沟淋巴结转移(P0.05)差异有统计学意义。结论:肿瘤组织学分级、肿瘤浸润淋巴管/血管、腹股沟淋巴结转移是PSCC预后独立预测因素。     

膀胱乳头状移行细胞癌中高危人乳头瘤病毒的检测

目的对高危人乳头瘤病毒（ＨＰＶ）１６、１８ＤＮＡ在膀胱癌组织中进行定位研究。方法运用地高辛标记的原位杂交技术对５２例膀胱乳头状移行细胞癌中高危ＨＰＶＤＮＡ进行检测。结果ＨＰＶＤＮＡ的阳性信号存在于肿瘤细胞核内,呈点状或点片状,其中以点状为主,约８９５％。癌旁不典型增生上皮、癌旁正常的上皮组织及Ｂｒｕｎｎ巢可同时有高危ＨＰＶ的感染,但表达呈点片状。５２例膀胱乳头状移行细胞癌中高危型ＨＰＶ１６、１８ＤＮＡ阳性１９例,阳性率为３６５％;ＰＴａＴ２期１７例,ＰＴ３Ｔ４期２例;Ｇ１,２级１４例,Ｇ３级５例。随着肿瘤分期分级的增加,ＨＰＶ１６及ＨＰＶ１８的感染率有逐渐降低的趋势,但差异无统计学意义（Ｐ＞００５）。结论病毒ＤＮＡ在膀胱癌变组织、癌旁正常及不典型增生组织中均有不同程度的表达。膀胱乳头状移行细胞癌ＨＰＶ感染率较高,浸润较浅分化较好的肿瘤更多见,提示该病毒感染可能是膀胱癌发生的早期诱因之一。     

58例阴茎鳞状细胞癌治疗的临床分析

目的:提高阴茎鳞状细胞癌的治疗水平,寻求鳞状细胞癌合理有效的治疗方法。方法:回顾分析58例病理活检证实阴茎鳞状细胞癌治疗的临床资料。结果:按照Jackson分期,Ⅰ期25例,Ⅱ期18例,Ⅲ期11例,Ⅳ期4例。53例行手术治疗;行阴茎肿瘤局部切除及阴茎癌部分切除43例;阴茎全切除并尿道会阴部造口术及髂腹股沟淋巴清扫术10例(腹股沟淋巴结均阳性,髂淋巴结阳性1例)。术前新辅助治疗(热疗加化疗)联合术后化疗37例,仅术后化疗12例,单纯手术治疗4例;5例未手术治疗患者行化疗和/或放疗。48例随访2~5年,4例行阴茎部分切除者2年内复发,4例2年内死亡,7例2~5年内死亡,2年生存率为91.7%,5年生存率为77.1%,10例失访或随访期未满2~5年。结论:外科手术治疗、术前新辅助治疗联合术后化疗是目前治疗阴茎鳞状细胞癌的有效方法,淋巴结的清扫根据临床分级具体处理,手术联合术前新辅助治疗及术后化、放疗是否可减少复发及提高生存率,还需进一步研究。     

82例阴茎鳞状细胞癌临床诊断与治疗

目的：提高阴茎鳞状细胞癌的诊断和治疗水平。方法：回顾性分析1980-2005年82例阴茎鳞状细胞癌患者临床资料,结合文献复习进行讨论。结果：77例病例行手术治疗,其中阴茎部分切除术64例,阴茎全切术13例。阴茎切除加髂腹股沟淋巴结清扫14例（腹股沟淋巴结均为阳性,髂淋巴结均为阴性）。放疗3例,化疗1例,放化疗联合治疗1例。71例患者随访1～10年,5例1年内死亡,17例2～5年内死亡,49例生存5年以上,占69％,其中34例生存10年,占48％,11例失访。结论：包茎、包皮过长是阴茎鳞状细胞癌的重要诱因;HPV感染可能与阴茎鳞状细胞癌发生有关。外科手术治疗是目前治疗阴茎鳞状细胞癌的有效方法;淋巴结清扫范围应采用由浅至深逐级切除的方式;放、化疗及联合治疗疗效尚不确切。     

阴茎假血管肉瘤样鳞状细胞癌(附1例报告)

目的 探讨阴茎假血管肉瘤样鳞状细胞癌(PASCC)的诊治方法.方法 回顾分析l例阴茎PASCC癌患者的临床资料,分析其发病情况、临床病理特征、诊断和治疗.结果 首次行阴茎部分切除、双侧腹股沟淋巴结清扫术(T2N2M0),辅以盆腔放疗,术后2个月,因阴茎皮瓣坏死(伴局部复发)再次行阴茎全部切除术.首次术后11个月,因肺部广泛转移死亡.肿瘤组织主要由梭形、多形性的肿瘤细胞和局灶的鳞状细胞癌细胞组成,排列呈血窦状血管样腔隙或网状结构.腹股沟淋巴结仅见普通型高分化鳞状细胞癌细胞(3/9.2/10).复发肿瘤的结构和形态与原发肿瘤相似.免疫组化染色示肿瘤细胞CK(AE1/AE3)、34 β E12、Vimentin(+),EMA呈灶性或片状(+).CD31、CD34、FⅧRAg、HMB45、SMA、Desmin(-).结论 阴茎PASCC是一种罕见的恶性肿瘤,确诊需依赖组织病理学及免疫组织化学检查,早就诊、早诊断和及时恰当的治疗是关键,但预后差.     

复发性尖锐湿疣恶变为阴茎鳞状细胞癌1例

尖锐湿疣长期复发未治愈,易发生恶变.我院于2001年2月收治1例复发性尖锐湿疣恶变为阴茎鳞状细胞癌的病人,现报告如下.     

膀胱砂状移行细胞癌中高危人乳头瘤病毒的检测

目的 地高危人乳头瘤病毒（ＨＰＶ）１６、１８ＤＮＡ在膀胱癌组织中进行定位研究。方法 运用地高辛标记的原位杂交技术对５２例膀胱砂状移行细胞癌中高危ＨＰＶＤＮＡ进行检测。结果 ＨＰＶＤＮＡ的阳性信号存在于肿瘤细胞核内，呈占 或点片状，其中以点状为主，经８９．５％。癌旁不典型增生上皮、癌旁正常的上皮组织及Ｂｒｕｎｎ巢可同时有高危ＨＰＶ的感染，但表达呈点片状。５２例胱乳头状移行细胞癌中高危型ＨＰＶ１６、１     

Squamous Cell Carcinoma Presenting as Peri-Implantitis: A Case Report

Dental implants have proved to be a useful adjunct in the rehabilitation of oral cancer patients. We describe the case of a 62-year-old woman who presented with a white patch in the oral cavity, diagnosed to be a squamous cell carcinoma. She underwent extensive surgery including microvascular reconstruction, followed by implant rehabilitation. Unfortunately, she suffered from multiple episodes of peri-implantitis and later on went on to develop oral squamous cell carcinoma around two of the dental implants. Here, we highlight the importance of regular follow-up and maintaining a high index of suspicion in high-risk patients.     

Thyroid Papillary Carcinoma Recurring as Squamous Cell Carcinoma: Report of a Case

We report a case of local squamous cell carcinoma recurrence of thyroid papillary carcinoma, 4 years after subtotal thyroidectomy, in an 82-year-old woman. The papillary cancer of the right thyroid was histopathologically classified as T2a, N0, M0, Ex1; pT2a, pN1b, pEx1; Stage III. Fine-needle aspiration cytology of the recurrent tumor revealed atypical squamous epithelium-like cells with keratinization. The tumor was judged cytologically to be class III, defined as a suspicious malignancy and, after reoperation, it was diagnosed histopathologically as papillary carcinoma recurrence with extensive squamous metaplasia. The recurrent papillary carcinoma was thought to have changed to a squamous cell carcinoma because most of the tumor was occupied by atypical squamous cells, with a small amount of glandular tissue. The primary tumor was histologically diagnosed as a well-differentiated papillary carcinoma at the initial operation. It contained numerous tall neoplastic cells with eosinophilic granules and pseudostratified nuclei, indicating that it could potentially transform into squamous cell carcinoma. We report this case as an example of how squamous cell carcinoma of the thyroid can develop.     

Association of Human Papillomavirus Type 11 with Carcinoma of the Penis

Human papillomaviruses (HPVs) are epithelium-tropic viruses associated with several cutaneous, epithelial, and mucosal lesions. The oncogenic potential varies considerably among the more than 70 different genotypes so far identified. HPV 6 and 11 are generally found in benign genital condilomata or laryngeal papillomas, but they have been sporadically associated with genital malignancies. Polymerase chain reaction (PCR) primed by degenerated consensus oligonucleotides (from a late region of the HPV genome) allows one to amplify a broad spectrum of HPV, whereas the amplification with specific primers is restricted to a limited number of HPVs. Therefore, the restriction fragment length polymorphism assay permits one to identify the HPV type present in the PCR product. We report a case of an invasive verrucous carcinoma of the penis associated with HPV 11, a type previously considered noncarcinogenic.     

Histological Features of Human Papilloma Virus 16 and Its Association with the Development and Progression of Anal Squamous Cell Carcinoma

Purpose To investigate the development of anal squamous cell carcinoma (SCC) and the expression patterns of human papillomavirus (HPV). Methods We performed typing of HPV-DNA using a polymerase chain reaction (PCR), and amplified the Duchenne muscular dystrophy (DMD) genes simultaneously, to investigate the tumor DNA state. The expression patterns of HPV in the cancer cell nuclei was investigated by in situ hybridization (ISH) using HPV probes. Results Amplification of DMD genes was confirmed in 8 of 20 patients with anal SCC, suggesting that tumor DNA was preserved in these patients. In seven of these eight patients, only HPV16 was detected by both PCR and ISH, suggesting HPV16-induced carcinogenesis. In two patients with carcinoma in situ (CIS), the cancer cells showed only a diffuse pattern (DP), and in two patients with invasive cancer, the cancer cell showed only an oligo-dot pattern (OP). In one patient with lesions ranging from CIS to invasive cancer, the histologic features varied in each area, from DP to OP. This change originated in the deep part of the microinvasive area. Conclusions These findings show that HPV16 infection is closely involved in the development of anal SCC and suggest that the change in the genome occurs at the stage of microinvasive cancer.     

Squamous Cell Carcinoma arising in a Giant Epidermal Cyst: a Case Report

Epidermal cysts are commonly encountered in surgical practice. Malignant degeneration of epidermal sebaceous cyst is uncommon. The authors report the case of a 38-year Filipino woman presenting with a voluminous sebaceous cyst of the left buttock. Ultrasonography and computer tomography were made preoperatively without any hint of eventual malignant degeneration. Marginal excision was performed with direct closure of the skin. The histological examination revealed epidermal sebaceous cyst with squamous cell carcinoma in situ, which is a quite rare, but well known complication occurring in sebaceous cysts.     

Squamous Cell Carcinoma In Situ of the Breast: Report of a Case

We present the case of a 73‐year‐old woman with pure squamous cell carcinoma in situ of the left breast. This non‐invasive malignancy exhibited pure squamous type of architectural and cytologic features without any evidence of glandular differentiation either in the initial needle core biopsy or in the subsequently performed excisional biopsy and simple mastectomy. The tumor spanned 1.6 cm, involved numerous ducts and terminal ducts and extended into lobules, and was characterized by keratinizing squamous cells with intermediate‐grade nuclei. Intercellular bridges extended between the malignant squamous cells. Keratinous debris with “pearl” formation was evident in most involved glands. No invasive carcinoma was identified. There was no evidence of metastatic disease in the ipsilateral sentinel lymph nodes. Thus far, only three cases of squamous cell carcinoma in situ of the breast have been reported in one series—none of which showed any evidence of recurrent or metastatic disease at last follow‐up. In our case, treated exclusively by surgery, there was no evidence of disease 11 years after diagnosis.     

Primary Squamous Cell Carcinoma of the Liver Arising from a Complex Liver Cyst: Report of a Case

A 65-year-old man who had received radiation therapy for nasopharyngeal cancer (NPC) 3 years earlier presented with a 3-week history of right upper quadrant abdominal pain and a feeling of fullness. There had been no evidence of metastasis on his follow-up examinations. Computed tomography scan showed a huge complex cyst with septa in the right hepatic lobe, and we performed an extended right hepatectomy to relieve his symptoms. Pathological examination revealed a large hepatic cyst with malignant cells along the cyst wall. The cytokeratin stain and CK-14 stains were positive, indicating an undifferentiated squamous cell carcinoma (SCC). The final diagnosis of primary SCC of the liver was confirmed by the clinical pathological features and negative in situ hybridization of Epstein–Barr ribonucleic acids (EBERs). We used EBERs to determine whether the cystic tumor was a primary lesion or a metastatic lesion from the previous NPC.