3.4 Treatment and Prognosis All the patients had different surgical treatmnet.The results of the follow-up survey show a favorable prognosis and that no patient died of this tumor until now.And it also proves that surˉgical treatment is the best and the first choice.

    There were more or less inflammatory cells invading the stroma in all cases.And46%of all cases had carciˉnolysis.The favorable prognosis is correlated with the body immunity against this tumor and the biological beˉhavior of it [5] 。

    The swelling of regional lymph nodes was often caused by inflammatory reaction，but it might be easily mistaken as metastasis.93%of all patients had swelling of regional lymph nodes and11cases were clinically misdiagnosed as being advanced stage and metastatic.But no evidence of metastasis was found by pathological

    examination in all lymph nodes taking from38patients.When diagnosing，the clinician should avoid taking the swelling of lymph nodes caused by inflammatory reaction as metastasis so as to let the patients miss the chance of surgical treatment.And it is also unnecessary to carry out the dissection of lymph nodes in every patients.We think biopsy should be made in the patients with swelling lymph nodes before or amid operation to assure whether metastasis have already occurred.

    The follow-up survey shows there is no significant difference among effects of surgical treatment of regional excision of tumor，partial or total amputation of penis and enlarging radical operation.According to the pathological changes and biological behavior of verrucous carcinoma of penis combining with the results

    of the follow-up survey，we think the following might be helpful to the surgical treatment:(1)It’s appropriate to have partial amputation of penis for the patients having verrucous carˉcinoma in the gland or prepuce and not necessarily to have total amputation and enlarging radical operation.The dissection of lymp

    h nodes would be performed only on the condition that biopsy proves metastasis really ocˉcurred in the regional lymph nodes.(2)For the patients having early stage，small and superficially invasive verruˉcous carcinoma of penis，especially in the young man，reˉgional excision of tumor is preferable，but the field of

    opˉeration should be large enough and the follow-up should also the carried out.Co-operation of clinician and pathologist is helpful for diagnosing verˉrucous carcinoma and taking appropriate surgical treatˉment measures.

    References

    1 Ackerman LV.Verrucous carcinoma of the oral cavity.surgery，1948，23:670.

    2 Lowe D，McKee PH.Verrucous carcinoma of penis(Buschke-Lowenˉ stein tumour):A clinicopathological study.Br J Urol，1983，55(4):427.

    3 Hanash KA，FurlowWL，Utz DC，et al.Carcinoma of the penis:A cliniˉcopathologic study.J Urol，19

    70，104:291.

    4 楼荣灿，黄美云，郑炳初.145例阴茎癌临床及疗效分析.中华肿瘤杂志，1984，6(3):223.

    5 王绪洲，李红，张轶.淋巴细胞浸润在阴茎癌预后中的意义.中华中西医杂志，2001，4:295.

    作者单位: 1 250012山东大学齐鲁医院病理科

              2 250011山东省济南市历下人民医院