口腔鱗狀細胞癌之早期發現─兩病例之報告

近年來口腔癌之發生率隨著嚼食檳榔人數之增加，有逐年上升之趨勢，口腔癌發生之年齡層亦有逐漸年輕化之現象。鑑於多數病人求診時已進入末期，預後不佳，如何使口腔癌於發生之早期便被發現，乃臨床醫師須不斷努力突破的目標。本文先以兩個病例，說明口腔癌被早期發現之病史經過。病例一為五十歲之男性病人，因為舌側緣突出之紅色病變於民國八十八年元月間至耳鼻喉科求診，其切片結果為輕度至中度上皮變異，由於病變持績存在，病人復於同年八月間至本科求診，於詳細理學檢查後，經切片檢查結果為早期之鱗狀細胞癌，乃於本院接受進一步評估及治療。病例二為五十一歲男性，具有口腔下唇黏膜疣狀增生之病史有數年之久，因為近口角處之唇聯合黏膜發生疼痛而求診，經廣泛性切除後，其病理結果為極早期之練細胞癌。文中將進一步探討口腔癌早期發現之相關臨床經驗，諸如：實施切片活體檢查之時機與方式之適切性，於病變發生惡性變化過程中與危險因子等之關係及後續治療方式之選擇等，以提高臨床醫師之警覺心，使口腔癌能早期發現。

關鍵字

口腔鱗狀細胞癌；早期發現；活體切片

並列摘要

Chewing of betel nut had been shown to correlate with induction of oral cancer in various studies. As betel has grown in popularity over the past decade in Taiwan, the number of deaths from oral cancer has more than doubled. The ability to detect and diagnose oral cancer in the earlier stage of the disease obviously has profound implications on the mortality and morbidity rates of the patients with disease. Two cases with early oral squamous cell carcinoma were presented in this article. The course and treatment of the cases as well as their early diagnosis and risk factors of oral squamous cell carcinoma were discussed. Cancer of the mouth can only be early diagnosed by clinicians with prepared minds using educated eyes and finger tips leading to prompt biopsy. To aid the dental clinician in the decision making process, using toluidine bule dye is recommended for the detection of squamous cell carcinoma.

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口腔鱗狀細胞癌之早期發現─兩病例之報告

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