Abstract:

Abstract：Objective To investigate the etiology of oral verrucous carcinoma，and its clinical manifestations，differential diagnosis，histopathological features and treatment. Methods Retrospectively analyze the clinical data of 86 cases of oral verrucous carcinoma confirmed by histopathologic diagnosis treated in Dental Hospital affiliated to China Medical University from 1990 to 2012，and summarize its clinical symptoms，imaging findings of focal area，pathology，treatment and postoperative follow-up. Results In 44 cases of 86 patients pure lesions enlarged resection was performed in 1.0 cm to 1.5 cm outside the mass edge; in 21 cases repair of adjacent flap transfer was performed besides lesion enlarged resection during the same period; in 11 cases lesion enlarged resection and Functional neck lymphadenectomy were performed, partial resection of jaw and lesion enlarged resection in 9 cases，lesion enlarged resection and submandibular gland excision on the right side and submandibular gland duct diversion in 1 case. In patients with postoperative follow-up survey， there were 3 recurrences in patients with simple resection in 5 years（including 1 patient with repair of adjacent flap in the same period），no recurrence in other cases. In the recurrence cases neoplasm enlarged resection was performed again，and there was no recurrence. Conclusion Verrucous carcinoma should be diagnosed by clinical manifestations，the microscopic morphology and biological behavior; radical surgery should be chosen as the preferred treatment; the patients should have postoperative re-examination and follow-up regularly.

Key words: oral verrucous carcinoma, diagnossis, treatment

摘要：

目的 探讨口腔疣状癌的病因、临床表现、鉴别诊断、组织病理学特点及治疗。方法 回顾分析中国医科大学附属口腔医院1990—2012年收治的86例经组织病理确诊的口腔疣状癌患者的临床资料，总结其临床症状、病灶区影像学表现、病理学表现、治疗方案及术后随访情况。结果 86例患者中44例于肿物边缘外1.0～1.5 cm单纯行病灶扩大切除，21例除行病灶扩大切除外均同期行临近瓣转移修复术，11例行病灶扩大切除及功能性颈淋巴结清扫术，9例行病灶扩大切除及颌骨部分切除术，1例行病灶扩大切除+右侧颌下腺摘除+颌下腺导管改道术。对术后患者随访调查，单纯行手术切除的患者术后5年内复发3例（其中包括同期行临近瓣修复患者1例），余未见复发。对复发病例再次行肿物扩大切除，未见复发。结论 疣状癌的诊断需靠临床表现、镜下形态以及生物学行为判断，外科根治性手术为首选治疗方案，术后应定期复查、随访。

关键词: 口腔疣状癌, 诊断, 治疗