squamous cell carcinoma of the head
Introduction
Introduction to head squamous cell carcinoma Squamous cell carcinoma (referred to as squamous cell carcinoma) is a keratinocyte originating from the epidermis or accessories such as sebaceous gland ducts, hair follicles, and sweat gland ducts. It is more common in older men and occurs in exposed parts such as the scalp, face, neck and back of the hand. basic knowledge The proportion of sickness: 0.001% - 0.005% Susceptible people: no specific population Mode of infection: non-infectious complication:
Cause
Head squamous cell carcinoma
(1) Causes of the disease
Since Percival Pott first reported in 1775 that chimney sweepers had scrotal squamous cell carcinoma due to exposure to soot, the pathogenesis of squamous cell carcinoma has been noted, among them, environmental factors such as sunlight, humidity, smog and climate, genetic factors, and skin color. Etc. is considered to be closely related to the occurrence of squamous cell carcinoma.
1. Ultraviolet light in the sun 1948 Blum proves that the carcinogenic ray is the part of the solar spectrum with a wavelength of 290-320 mm.
2. Chemical factors Some chemical substances such as arsenic and asphalt can cause skin squamous cell carcinoma. The incidence of skin squamous cell carcinoma in workers exposed to asphalt is about 12 times higher than that of ordinary workers.
3. Ethnic factors The incidence of colored people is higher than that of Caucasians. Domestic Sun Shaoqian reported 191 cases of skin cancer in 1956, of which squamous cell carcinoma accounted for 78.5%, while Germany Bosenberg reported in 133 cases of 133 cases of skin cancer. 15%.
4. Precancerous skin disease Precancerous dermatitis, X-ray and radium ray dermatitis, actinic keratosis, arsenic keratosis, etc. are all likely to cause squamous cell carcinoma.
5. Scars A variety of traumatic scars, especially burn scars are more likely to develop squamous cell carcinoma.
(two) pathogenesis
Squamous cell carcinoma generally differentiates well, and highly differentiated squamous cell carcinoma accounts for about 75%. The cancer cells are papillary, nested, strip-like or adenoid, and can be infiltrated into the dermis or subcutaneous tissue. level:
1. Grade I differentiated mature squamous cell carcinoma with intercellular bridge and cancer beads. Cancer beads are characteristic structures of squamous cell carcinoma and are composed of concentrically arranged angular cancer cells.
2. Grade II is based on spine cells and has obvious heteromorphism, including enlargement of cancer cells, different nuclear sizes, different staining depths, more common nuclear division, fewer cancerous beads, and central keratosis. .
3. Class III cells are poorly differentiated, most of the cells in the epidermis are disordered, the cell volume is enlarged, the nucleus is large and the shape is obvious, the mitosis is more common, and there is no cancerous bead, but some cells are keratinized, and the lesion is radial in the epidermis. Expanded and infiltrated the leather later.
4. Grade IV is undifferentiated, no spine cells, no intercellular bridge and cancerous beads, the cancer is finely fusiform, the nucleus is slender and stained deeply, and there are necrotic and pseudo-adenoid structures, and a few are squamous cells and keratinized. Cells can be used as a basis for diagnosis.
Prevention
Head squamous cell carcinoma prevention
Take care to avoid excessive exposure to UV rays and frequent exposure to chemicals such as arsenic and asphalt.
Complication
Head squamous cell carcinoma complications Complication
As the tumor develops, it may be accompanied by damage to the cartilage, muscles, bones, etc., and may be transferred to the lymph nodes.
Symptom
Head squamous cell cancer symptoms common symptoms squamous cell carcinoma papular nodules squamous scales
Primary squamous cell carcinoma is rare, early is a small papule, nodular or sacral, reddish, rough surface, rapid growth and easy to rupture and infiltrate into the periphery, more common in the top of the head, secondary squamous cell carcinoma See, often caused by cancer on the basis of chronic ulcers, scars and other damage on the original scalp. According to clinical morphology, there are usually two types:
Cauliflower type
Initially infiltrating small plaques, small nodules or ulcers, followed by papillary to cauliflower-like bulge, reddish, broad base, hard, telangiectasia on the surface, accompanied by scales and scars, often in the central area Nail-like keratin, if it is peeled off, the bottom is prone to bleeding, this type of face and limbs are more common.
Deep type
Initially a reddish hard nodule, the surface is smooth, gradually increasing, the umbilical depression appears in the center, new nodules are formed around it, volcanic ulcers form after rupture, the edge is uplifted, the quality is hard, the bottom of the ulcer is uneven, and the wound has Dirt necrotic tissue and pus-like secretions, stinking, the lesions develop faster and infiltrate deep into the skull, may have early regional lymph node metastasis, but also have metastasis through the blood, but rare.
According to the international TNM (tumor nodes metastasis) classification, squamous cell carcinoma can be divided into:
T: primary lesion seen by the naked eye
T1s: intraepithelial cancer
T0: initial tumor
T1: The maximum diameter of the tumor is 2cm or less
T2: The maximum diameter of the tumor is 2cm or more and 5cm or less (infiltrated into the superficial layer of the dermis)
T3: The maximum diameter of the tumor is more than 5cm (infiltrated into the deeper layers of the skin)
T4: Tumor invasion to other tissues (cartilage, muscle, bone)
N: lymph node metastasis seen by the naked eye
N0: untwisted lymph nodes
N1: sputum and ipsilateral lymph nodes
N2: sputum and bilateral lymph nodes, ipsilateral lymph node fixation
N3: sputum and bilateral lymph nodes, contralateral lymph node fixation
M: Is there a distant transfer?
M0: no distant transfer
M1: There is a distant transfer
In the above classification, T1 to T4 are at N0, and M0 rarely causes death. On the contrary, the prognosis is poor in N1M1.
Examine
Examination of head squamous cell carcinoma
Tumor marker detection, skin smear microscopy, skin fungal microscopy, physical examination of skin diseases, skin elasticity test, skin color, tumor markers (Tumor Marker) are chemical substances that reflect the presence of tumors. They may or may not exist in Normal adult tissues are only found in embryonic tissues, or the content in tumor tissues is much higher than that in normal tissues. Their presence or quantitative change can indicate the nature of tumors, so as to understand the tumor tissue, cell differentiation, and cell function. Help with the diagnosis, classification, prognosis and treatment guidance of tumors.
Diagnosis
Diagnosis and differentiation of head squamous cell carcinoma
The disease is more common in patients over 50 years old. The lesions often have damaged scars or ulcers. The lesions are hard and have nodules or plaques. The edges are raised and the growth is faster.
Squamous cell carcinoma should be differentiated from benign chronic ulcers and tuberculous ulcers. It is similar to basal cell carcinoma in the early stage and can be diagnosed by pathological examination.
