| ObjectiveVerrucous carcinoma(VC)is a low-grade malignant squamous cell carcinoma which is rare in clinics.Its occurrence is closely related to bad behaviors,such as smoking,drinking,unclean sex,etc.It often occurs in the oral cavity,genital anal and foot plantar area,with insidious onset,lack of specific clinical manifestations and rapid early growth.Clinical misdiagnosis and delayed treatment often lead to loss of aesthetics and body function of patients,so early diagnosis and timely surgery are still the basic principle of prevention and treatment of verrucous carcinoma.Radiotherapy and chemotherapy can reduce recurrence and improve prognosis to a certain extent after surgery.At present,the domestic and foreign literature mostly focuses on case report on verrucous carcinoma,the existing research lacks retrospective analysis of the verrucous carcinoma systematically.This study collected complete clinical medical records of patients with verrucous carcinoma in our hospital,combing with postoperative follow-up investigations.It conducted a comprehensive analysis of the clinical features,treatment methods and prognosis of verrucous carcinoma,which provides more theoretical support for clinicians to diagnose and treat the disease and more scientific advice for the prevention of verrucous carcinoma.MethodThe clinical data and follow-up results of 90 patients with verrucous carcinoma Who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2020 were collected in this study.All patients underwent surgical treatment and were diagnosed by the pathology department and Henan provincial pathology consultation center.A retrospective analysis of the patient’s gender,age,course of disease,distribution area,clinical manifestations,misdiagnosis,pathogenic factors,surgical treatment and prognosis were analyzed retrospectively.SPSS25.0 statistical software was used for statistical analysis on the data(P<0.05 means the difference is statistically significant).Result1.Epidemiology:60 cases(66.7%)were males,30 cases(33.3%)were females,the ratio of male to female ratio was 2:1.The age diagnosed as VC was from 37 to 88 years old(mid age 62 years old).The course ranged from 1 to 48 months(mid-course 6 months).The oral cavity,genital anal and foot plantar area were the common sites of disease which had 31 cases(34.44%),39 cases(43.33%)and 11 cases(12.22%)respectively.2.Clinical manifestations:The diameter of the lesions ranged from 0.3 to 12.0 cm,(mid diameter 2.0 cm)while 71 lesions(74.0%)were between 1.0 to 3.0 cm.most lesions were brown(44,45.83%)in color.The appearance was mostly like cauliflower(76,83.33%)and the shape of the base was mainly irregular(59,61.46%).The lesions showed hard texture mainly(77,80.21%).Most of the lesions had tenderness(64,66.67%).Most of the lesions manifested rough surface(91,94.79%),42 lesions accompanied by ulcer formation.3.Etiology analysis:The difference in the incidence of OVC bettween men with and without long-term smoking or drinking history was statistically significant(P=0.009);the difference in the incidence of OVC among women with different oral hygiene levels was statistically significant(P=0.008);The difference in the incidence of penile verrucous carcinoma between men with and without penile long foreskin or phimosis(P=0.003);there was no statistically significant difference in the incidence of genital verrucous carcinoma between women with and without inflammation of the genitourinary system;Ten patients(55.56%)tested positive for HPV among 18 patients for the test.4.Diagnosis and differential diagnosis:11 cases were diagnosed as VC before surgery,with a coincidence rate of 12.22%.67 cases underwent rapid frozen pathological examination,49 cases were diagnosed as VC,with a coincidence rate of 12.22%.82 cases were diagnosed as VC by routine pathological examination,with a coincidence rate of 91.11%.The remaining 8 cases were finally diagnosed after the provincial pathology consultation.Misdiagnosed diseases include well-differentiated squamous cell carcinoma,papilloma,verrucous hyperplasia and condyloma acuminatum,etc.5.Treatment and prognosis:All patients underwent surgical treatment.81 cases out of 90 patients healed in stage I.The patients were followed up by the telephone or outpatient department after surgery,with a interval from 3 months to 6 year,5 cases had recurrence after surgery,3 cases were lost and 82 cases did not relapse.The patients with recurrence did not relapse after recent surgical treatment.Conclusions1.VC usually occurs in middle-aged and elderly people.The incidence rate of men is higher than that of women.The lesions are mostly distributed in the oral cavity,genitals,anus and foot plantar areas.2.VC doesn’t have specific clinical manifestation and the pathological tissue is well differentiated.It is easy to be misdiagnosed both clinically and pathologically.3.VC is mainly related to bad behaviors,local chronic irritation,long-term inflammation and low immunity of the body.4.Surgical resection is the first choice for the treatment of verrucous carcinoma,the postoperative recurrence rate is low. |
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