Marjolin’s溃疡的临床研究现状
Current Status of Clinical Research on Marjolin’s Ulcer
DOI: 10.12677/acm.2025.1572139, PDF,   
作者: 杨琪瑛, 罗玉明:西安医学院研究生院,陕西 西安;空军军医大学第一附属医院烧伤与皮肤外科,陕西 西安;刘梦栋, 高晓文, 李 军*:空军军医大学第一附属医院烧伤与皮肤外科,陕西 西安
关键词: Marjolin’s溃疡病因及发病机制临床特点病理类型诊断与治疗预后研究现状Marjolin’s Ulcer Etiology and Pathogenesis Clinical Characteristics Pathological Types Diagnosis and Treatment Prognosis Current Research Status
摘要: Marjolin’s溃疡是指在先前烧伤、创伤、慢性炎症、瘢痕皮肤或放射治疗后的瘢痕区域出现的一种非常罕见、侵袭性恶性溃疡。Marjolin’s溃疡的潜伏期长,往往容易被忽视。本研究对Marjolin’s溃疡的研究现状进行归纳总结,以期提高临床对该病的认识。
Abstract: Marjolin’s ulcer is a highly rare and aggressive malignant ulcer that occurs in scarred areas following previous burns, trauma, chronic inflammation, scarred skin, or radiation therapy. Characterized by a long latency period, Marjolin’s ulcer is often neglected. This study aims to summarize the current research status on Marjolin’s ulcer to enhance clinical awareness of this condition.
文章引用:杨琪瑛, 罗玉明, 刘梦栋, 高晓文, 李军. Marjolin’s溃疡的临床研究现状[J]. 临床医学进展, 2025, 15(7): 1397-1404. https://doi.org/10.12677/acm.2025.1572139

参考文献

[1] Dupree, M.T., Boyer, J.D. and Cobb, M.W. (1998) Marjolin’s Ulcer Arising in a Burn Scar. Cutis, 62, 49-51.
[2] Lawrence, E.A. (1952) Carcinoma Arising in the Scars of Thermal Burns, with Special Reference to the Influence of the Age at Burn on the Length of the Induction Period. Surgery Gynecology & Obstetrics, 95, 579-588.
[3] Mosborg, D.A., Crane, R.T., Tami, T.A. and Parker, G.S. (1988) Burn Scar Carcinoma of the Head and Neck. Archives of OtolaryngologyHead and Neck Surgery, 114, 1038-1040. [Google Scholar] [CrossRef] [PubMed]
[4] Novick, M., Gard, D.A., Hardy, S.B. and Spira, M. (1977) Burn Scar Carcinoma. The Journal of Trauma: Injury, Infection, and Critical Care, 17, 809-817. [Google Scholar] [CrossRef
[5] Esther, R.J., Lamps, L. and Schwartz, H.S. (1999) Marjolin Ulcers: Secondary Carcinomas in Chronic Wounds. Journal of the Southern Orthopaedic Association, 8, 181-187.
[6] Sharma, A., Schwartz, R.A. and Swan, K.G. (2010) Marjolin’s Warty Ulcer. Journal of Surgical Oncology, 103, 193-195. [Google Scholar] [CrossRef] [PubMed]
[7] Thompson, A.K., Kelley, B.F., Prokop, L.J., Murad, M.H. and Baum, C.L. (2016) Risk Factors for Cutaneous Squamous Cell Carcinoma Recurrence, Metastasis, and Disease-Specific Death: A Systematic Review and Meta-Analysis. JAMA Dermatology, 152, 419-428. [Google Scholar] [CrossRef] [PubMed]
[8] Bostwick, J., Pendergrast, W.J. and Vasconez, L.O. (1976) Marjolins Ulcer. Plastic and Reconstructive Surgery, 57, 66-69. [Google Scholar] [CrossRef
[9] Kerr-Valentic, M.A., Samimi, K., Rohlen, B.H., Agarwal, J.P. and Rockwell, W.B. (2009) Marjolin’s Ulcer: Modern Analysis of an Ancient Problem. Plastic & Reconstructive Surgery, 123, 184-191. [Google Scholar] [CrossRef] [PubMed]
[10] 沈锐, 张金明, 张凤刚, 等. 慢性皮肤溃疡癌变与癌基因Ras, C-myc异常表达的关系[J]. 中华临床医师杂志(电子版), 2017, 11(18): 2237-2240.
[11] Harland, D.L., Robinson, W.A. and Franklin, W.A. (1997) Deletion of the P53 Gene in a Patient with Aggressive Burn Scar Carcinoma. The Journal of Trauma: Injury, Infection, and Critical Care, 42, 104-107. [Google Scholar] [CrossRef] [PubMed]
[12] Lee, S.H., Shin, M.S., Kim, H.S., Park, W.S., Kim, S.Y., Jang, J., et al. (2000) Somatic Mutations of Fas (Apo-1/CD95) Gene in Cutaneous Squamous Cell Carcinoma Arising from a Burn Scar. Journal of Investigative Dermatology, 114, 122-126. [Google Scholar] [CrossRef] [PubMed]
[13] 夏琛, 褚志刚. Marjolin溃疡鳞状细胞癌中BRAF V600E突变的临床意义[J]. 局解手术学杂志, 2022, 31(3): 221-225.
[14] Sinha, S., Su, S., Workentine, M., Agabalyan, N., Cheng, M., Gabriel, V., et al. (2017) Transcriptional Analysis Reveals Evidence of Chronically Impeded ECM Turnover and Epithelium-To-Mesenchyme Transition in Scar Tissue Giving Rise to Marjolin’s Ulcer. Journal of Burn Care & Research, 38, e14-e22. [Google Scholar] [CrossRef] [PubMed]
[15] Nthumba, P.M. (2010) Marjolin’s Ulcers: Theories, Prognostic Factors and Their Peculiarities in Spina Bifida Patients. World Journal of Surgical Oncology, 8, Article No. 108. [Google Scholar] [CrossRef] [PubMed]
[16] Copcu, E. (2009) Marjolin’s Ulcer: A Preventable Complication of Burns? Plastic and Reconstructive Surgery, 124, 156e-164e. [Google Scholar] [CrossRef
[17] Enoch, S., Miller, D.R., Price, P.E. and Harding, K.G. (2004) Early Diagnosis Is Vital in the Management of Squamous Cell Carcinomas Associated with Chronic Non Healing Ulcers: A Case Series and Review of the Literature. International Wound Journal, 1, 165-175. [Google Scholar] [CrossRef] [PubMed]
[18] Hayashi, M., Tamura, G., Kato, N., Ansai, S., Kondo, S. and Motoyama, T. (2003) Genetic Analysis of Cutaneous Squamous Cell Carcinomas Arising from Different Areas. Pathology International, 53, 602-607. [Google Scholar] [CrossRef] [PubMed]
[19] Hill, L.L., Ouhtit, A., Loughlin, S.M., Kripke, M.L., Ananthaswamy, H.N. and Owen-Schaub, L.B. (1999) Fas Ligand: A Sensor for DNA Damage Critical in Skin Cancer Etiology. Science, 285, 898-900. [Google Scholar] [CrossRef] [PubMed]
[20] Tavares, E., Martinho, G., Dores, J.A., Vera-Cruz, F. and Ferreira, L. (2011) Úlcera de Marjolin associada a ulceração e osteomielite crônicas. Anais Brasileiros de Dermatologia, 86, 366-369. [Google Scholar] [CrossRef] [PubMed]
[21] Hahn, S.B., Kim, D.J. and Jeon, C.H. (1990) Clinical Study of Marjolin’s Ulcer. Yonsei Medical Journal, 31, 234-241. [Google Scholar] [CrossRef] [PubMed]
[22] Tiftikcioglu, Y.O., Ozek, C., Bilkay, U., Uckan, A. and Akin, Y. (2010) Marjolin Ulcers Arising on Extremities. Annals of Plastic Surgery, 64, 318-320. [Google Scholar] [CrossRef] [PubMed]
[23] 鲁开化, 汪良能, 徐名达, 等. 烧伤瘢痕癌的预防、早期诊断与治疗的探讨[J]. 中华整形烧伤外科杂志, 1985(4): 258-260, 323.
[24] 季正伦, 郭恩覃. 皮肤瘢痕癌六例报告[J]. 中华整形烧伤外科杂志, 1993(6): 428-430, 478.
[25] 张兆祥. 烧伤瘢痕鳞状细胞癌[J]. 中华整形烧伤外科杂志, 1993(6): 425-427, 478.
[26] 谢尔凡. 烧伤瘢痕癌197例综合分析[J]. 癌症, 1995(4): 309-310.
[27] Iqbal, F.M., Sinha, Y. and Jaffe, W. (2015) Marjolin’s Ulcer: A Rare Entity with a Call for Early Diagnosis. BMJ Case Reports, 2015, bcr2014208176. [Google Scholar] [CrossRef] [PubMed]
[28] Kannan, R.Y. and Rauf, G.K. (2010) Acute Burn Scar Basal Cell Carcinoma. Annals of Plastic Surgery, 64, 321-322. [Google Scholar] [CrossRef] [PubMed]
[29] Hwang, K., Han, J.Y. and Lee, S.I. (2004) Multiple Malignant Melanomas at Different Burn Scar Areas: A Case Report. Dermatologic Surgery, 30, 562-565. [Google Scholar] [CrossRef] [PubMed]
[30] Alconchel, M.D., Olivares, C. and Alvarez, R. (1997) Squamous Cell Carcinoma, Malignant Melanoma and Malignant Fibrous Histiocytoma Arising in Burn Scars. British Journal of Dermatology, 137, 793-798. [Google Scholar] [CrossRef] [PubMed]
[31] Yücel, A., Yazar, Ş., Demirkesen, C., Durak, H., Dervişoğlu, S. and Altıntaş, M. (2000) An Unusual Long-Term Complication of Burn Injury: Malignant Fibrous Histiocytoma Developed in Chronic Burn Scar. Burns, 26, 305-310. [Google Scholar] [CrossRef] [PubMed]
[32] Aydoğdu, E., Yildirim, S. and Aköz, T. (2005) Is Surgery an Effective and Adequate Treatment in Advanced Marjolin’s Ulcer? Burns, 31, 421-431. [Google Scholar] [CrossRef] [PubMed]
[33] Bloemsma, G.C. and Lapid, O. (2008) Marjolinʼs Ulcer in an Amputation Stump. Journal of Burn Care & Research, 29, 1001-1003. [Google Scholar] [CrossRef] [PubMed]
[34] Bozkurt, M., Kapi, E., Kuvat, S.V. and Ozekinci, S. (2010) Current Concepts in the Management of Marjolinʼs Ulcers: Outcomes from a Standardized Treatment Protocol in 16 Cases. Journal of Burn Care & Research, 31, 776-780. [Google Scholar] [CrossRef] [PubMed]
[35] Copcu, E., Sivrioglu, N., Baytekin, C., Koc, B. and Er, S. (2005) Very Acute and Aggressive Form of Marjolin’s Ulcer Caused by Single Blunt Trauma to the Burned Area. Journal of Burn Care & Rehabilitation, 26, 459-460. [Google Scholar] [CrossRef] [PubMed]
[36] Phillips, T.J., Salman, S.M., Bhawan, J. and Rogers, G.S. (1998) Burn Scar Carcinoma. Dermatologic Surgery, 24, 561-565. [Google Scholar] [CrossRef] [PubMed]
[37] Fairbairn, N.G. and Hamilton, S.A. (2011) Management of Marjolin’s Ulcer in a Chronic Pressure Sore Secondary to Paraplegia: A Radical Surgical Solution. International Wound Journal, 8, 533-536. [Google Scholar] [CrossRef] [PubMed]
[38] Khan, K., Giannone, A.L., Mehrabi, E., Khan, A. and Giannone, R.E. (2016) Marjolin’s Ulcer Complicating a Pressure Sore: The Clock Is Ticking. American Journal of Case Reports, 17, 111-114. [Google Scholar] [CrossRef] [PubMed]
[39] Chalya, P.L., Mabula, J.B., Rambau, P., Mchembe, M.D., Kahima, K.J., Chandika, A.B., et al. (2012) Marjolin’s Ulcers at a University Teaching Hospital in Northwestern Tanzania: A Retrospective Review of 56 Cases. World Journal of Surgical Oncology, 10, Article No. 38. [Google Scholar] [CrossRef] [PubMed]
[40] Thio, D., Clarkson, J.H.W., Misra, A. and Srivastava, S. (2003) Malignant Change after 18 Months in a Lower Limb Ulcer: Acute Marjolin’s Revisited. British Journal of Plastic Surgery, 56, 825-828. [Google Scholar] [CrossRef] [PubMed]
[41] Tobin, C. and Sanger, J.R. (2014) Marjolin’s Ulcers: A Case Series and Literature Review. Wounds, 26, 248-354.
[42] Knudsen, M.A. and Biering-Sørensen, F. (2007) Development of Marjolin’s Ulcer Following Successful Surgical Treatment of Chronic Sacral Pressure Sore. Spinal Cord, 46, 239-240. [Google Scholar] [CrossRef] [PubMed]
[43] Blank, A.A. and Schnyder, U.W. (1990) Squamous Cell Carcinoma and Basal Cell Carcinoma within the Clinical Picture of a Chronic Venous Insufficiency in the Third Stage. Dermatology, 181, 248-250. [Google Scholar] [CrossRef] [PubMed]
[44] Combemale, P. (2012) Malignancy and Chronic Leg Ulcers: The Value of Systematic Wound Biopsies: A Prospective, Multicenter, Cross-Sectional Study. Archives of Dermatology, 148, 704-708. [Google Scholar] [CrossRef] [PubMed]
[45] Reich‐Schupke, S., Doerler, M., Wollina, U., Dissemond, J., Horn, T., Strölin, A., et al. (2015) Squamous Cell Carcinomas in Chronic Venous Leg Ulcers. Data of the German Marjolin Registry and Review. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 13, 1006-1013. [Google Scholar] [CrossRef] [PubMed]
[46] Combemale, P., Bousquet, M., Kanitakis, J. and Bernard, P. (2007) Malignant Transformation of Leg Ulcers: A Retrospective Study of 85 Cases. Journal of the European Academy of Dermatology and Venereology, 21, 935-941. [Google Scholar] [CrossRef] [PubMed]
[47] Alcolado, J.C., Ray, K., Baxter, M., Edwards, C.W. and Dodson, P.M. (1993) Malignant Change in Dermatitis Artefacta. Postgraduate Medical Journal, 69, 648-650. [Google Scholar] [CrossRef] [PubMed]
[48] Møller, R. (1979) Metastases in Dermatological Patients with Squamous Cell Carcinoma. Archives of Dermatology, 115, 703-705. [Google Scholar] [CrossRef] [PubMed]
[49] Kasse, A.A., Betel, E., Dem, A., et al. (1999) [Cancers in the Scars of Thermal Burns (Apropos of 67 Cases)]. Dakar Médical, 44, 206-210.
[50] Edwards, M.J. (1989) Squamous Cell Carcinoma Arising in Previously Burned or Irradiated Skin. Archives of Surgery, 124, 115-117. [Google Scholar] [CrossRef] [PubMed]