口腔疣狀癌：73個病例分析

Oral Verrucous Carcinoma : An Analysis of 73 Cases

陳百立(Bai-Li Chen) ； 林正仲(Cheng-Chung Lin) ； 陳中和(Chung-Ho Chen)

《中華民國口腔顎面外科學會雜誌》 11卷1期 (2000/03) Pp. 11-17

https://doi.org/10.7104/CJOMS.200003.0011

摘要

Ackerman於1948年首先提出口腔疣狀癌是一種生長緩慢的鱗狀細胞癌的異型，在臨床上不易與鱗狀細胞癌或疣狀上皮增生來加以區別。其組織病理學上的特徵為正型或亞型上皮增生，上皮有向下推擠增生等變化，與疣上皮增生其他良性病變不易區別，必須仔細鑑別診斷，而對於其致病因素與治療法並未有一致結論。本研究針對高雄醫學大學自1992至1997年經斷為口腔疣狀癌的73個病例作一臨床研究調查。西方世界的研究發現與煙草的使用有關，但在本研究發現在台灣地區嚼食檳榔是最重要的致病因子。好發部位依序為頰黏膜，唇與舌，且男性遠多於女性，發病年齡有年輕化的趨勢。而不論是使用手術或放射線治療復發率都是相當高的，術後必須在臨床上做密切追蹤。

關鍵字

口腔疣狀癌

並列摘要

Verrucous carcinoma was first used by Ackerman in 1948 as a specific term to describe the slow-growing, fungating and verrucous variant of squamous cell carcinoma. The clinical appearance of verrucous carcinoma is distinguished difficultly from verrucous hyperplasia and squamous cell carcinoma. Histopathologically, it shows a hyperplastic lesion with hyper-ortho - and/or parakeratosis and blunt invasion of well polarized epithelial pegs. It is also difficult to distinguished from verrucous hyperplasia and other benign papillary lesions. There is much confusion in literature as to the etiologic factors and appropriate therapeutic method. In this clinic study, seventy-three cases of oral verrucous carcinoma were retrospectively col1eded from Kaohsiung Medical University Hospital from 1992 to 1997 for clinic study. Nearly all reports in Western countries found a connection between the development of verrucous carcinoma and the use of tabacco. The present study revealed betel quid chewing 1S the most possible etiologic factor for oral verrucous carcinoma in Taiwan area. The most common site of occurrence of oral verrucous carcinoma was the buccal mucosa followed by the lip and tongue. Males are significant1y predominant. The mean age of occurrence in Taiwan was seem younger than those of Western reports. The recurrent rate was high whether treated by surgery and/or radiotherapy. Terefore, a dose postoperative follow-up is required.