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材T`~Fだ戳
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材き`龟喷のgu厩浪d
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潮掺砾b瓣uk┦砾gぃ1%C沮矫ネp参pAbxW潮掺のㄤL~ネ崔竟xぇ砾g~oネvA@VpCQUH1HCq1980~1993~矫ネp@nOF618fㄒAキАC~X{50sfㄒCHチ瓣1993~ㄒA赣~xWsfㄒ度53HA]O耕ぶǎcЭt参砾g[i]CNxWa跋C~潮掺のㄤLk┦ネ崔竟x砾gC~E_H计C瓜1-1C
材@`yf厩
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s陪ボAP潮掺砾ぇoネ程Τ闽YMI]lAO潮掺Ы场ぃ矫ネ┮yΘCXGSΤ@XネN澄]ブH|o潮掺砾CΤz阶{]ブ]|yΘ]ブのtYC┦oAτ护o砾┦跑てC]ΤH{PlcV砾闽H摸ㄅFfr（humanpapillomavirus）AP潮掺砾ぇoネ]Τ闽Y[ii]C
材G`of诀Pfz
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o@矗Oiゅんf（Bowenˉsdisease）AウO@贺キ灿M砾（squamouscellcarcinoma）砾（carcinomainsitu）（瓜2-1）Aq`{b潮掺ブ涧W钩Τ挡m（encrustation）pZ遏CtΤ@贺PIデ┦潮掺砾`Psb风んブWネg（erythroplasiaofQueyrat）CMikhailん纯厨i蔼F1/3贺fHAPΤ潮掺砾sb[iii]C
潮掺ぇIデ┦砾Hキ灿M砾D（瓜2-2）Aoネ场HtY程hAΩぇO]ブの潮掺DFA~[i钩Oㄅ┪检号（瓜2-3）C
材T`~Fだ戳
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材@戳G砾F度IデtYの]ブ
材G戳G砾FIデ潮掺DF
材T戳Giち埃浮肪Oぺ挡锣簿
材|戳G砾FIデ潮掺Fぇ~ALkち埃浮肪Oぺ挡锣簿A┪环B锣
~tΤTNMだ戳kp3-1C
3-1.潮掺砾ぇだ戳（InternationalUnionAgainstCancerSystem）[v]
Primarytumor（T）
Noevidenceofprimarytumor
Carcinomainsitu
Noninvasiveverrucouscarcinoma
Tumorinvadessubepithelialconnectivetissue
Tumorinvadesthecorpusspongiosumorcavernosum
Tumorinvadestheurethraorprostate
Tumorinvadesotheradjacentstructures
Regionallymphnodes（N）
Noregionallymphnodemetastasis
Metastasisinasinglesuperficialinguinallymphnode
Metastasisinmultipleorbilateralsuperficialinguinallymphnodes
Metastasisindeepinguinalorpelviclymphnode（s）,unilateralorbilateral
Distantmetastasis
Nodistantmetastasis
Distantmetastasis
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材き`龟喷のgu厩浪d
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潮掺场ち埃N
YOIデ┦潮掺砾AhBzhOЧ俱ち埃AB莱Τì镑w娩t（safetymargin）CYOb]ブWpf_AiH钡@]ブ吏ちN（circumcision）τOd潮掺Ч俱┦CYf_度tY┪潮掺环狠1/3AiH@潮掺场ち埃N（partialpenectomy）AOdぶ2そだw娩tANsЭDfぇH饯~陆_ブ涧WA磷KらЭDfUC场潮掺ち埃NヘO辨琵fH帝pKAㄏЭWVeよAτぃ|wb壳lWA~临iOΤk_の┦ユ\C
潮掺ち埃N
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Ы场Oぺ挡BmAPㄤL砾gBzhぃjPC]WL@bHWfHAㄤ浮肪Oぺ挡~jAO]oは莱yΘ[vi]C]fHYΤ浮肪Oぺ挡~jAゲ惠b潮掺lf_ち埃AHs┦кネv励46gCYOぺ挡bv励アAhjiぃゲ@Oぺ挡ぇXMN（lymphnodedissection）A]ㄤ~jOЫ场PVのoは莱τyΘ[vii]CYOぺ挡尿~jAhゲ惠{w砾灿Mw锣簿A惠@ㄢ凹浮肪のz癌Oぺ挡（iliaclymphnode）ぇXMNCYlf_材G材T戳ぇ~FAΤH某N衡NぃOぺ挡A]莱@@pd瞅Oぺ挡妓（sampling）AHTw锣簿ぇΤL[viii],[ix]CYfHセㄓSΤOぺ挡~jAlf_ち埃H~XAhn癸~jぇOぺ挡@Oぺ挡XMNC
@H癸H潮掺ち埃ㄓv励潮掺砾A`OKぃF|ΤU贺{みz承端（psychologicaltrauma）C]Τ\h沽刚Od潮掺\v励よΑA]Aguv励单CΤ@兜jso{AHもNち埃潮掺┪Oguv励AㄓBzof_（primarytumor）Aㄤv励挡GSΤぃP[x],[xi]C埃F砰~gu酚gAg┦v-192妮u从J（Iridium-192wireimplant）AGiㄏ┮Τv励fHO┦\[xii]A]O@贺匡拒Cguv励]ノ秆埃gAㄒpGkhAX┪溃┦g单C
Y~F┪Ы场Oぺ挡びjAiH@ō┦て厩v励AYpY{AAち埃もNCY~Fw憨┑ōAhiσ{@ō┦て厩v励A`ノて厩媚Cb7-1C潮掺砾癸て厩v励は莱v（responserate）b3050%ぇ丁A@ㄓ弧Aぶǎ戳w秆（long-termremission）C
7-1.潮掺砾`ノ虫@て厩v励媚の励
95%H苦跋丁
[xiii]A[xiv]
Methotrexate
[xv]A[xvi]
[xvii]A[xviii]
潮掺砾w
潮掺砾wMㄤ~FIデ{Τj闽CYSΤOぺ挡锣簿Ah5~svΤ65%90%CYIデOぺ挡Ah度Τ3050%ぇ5~svCYwIデz癌Oぺ挡hC20%AYΤㄤL竟x┪癌f锣簿A@fHぃ|L5~C
xj洛|q19761995~A@20~丁Av励F97潮掺砾ぇfㄒAㄤキА~闹57.6∮16.7烦Cㄤい88gfz厩TwAㄤい79Hil萝ㄤspA材@の材G戳（Ν戳）fH@57A]潮掺砾`度Τ2HAs戳い计|ゼFC材Tの材|戳fH@22A`Τ9HAs戳い计57るAPΝ戳fHぇs戳Τ陪参pWぇt钵[xix]（瓜7-1）C
[1].い地チ瓣F|矫ネp砾gnO厨iAチ瓣69~82~C
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3.MikhailGR:Cancers,precancersandpseudocancerofthemalegenitalia:Areviewofclinicalappearances,histopathology,andmanagement.JDermatolSurgOncol1980;6:1027.
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5.HermanekP,SobinLH,eds.TNMclassificationofmalignanttumors.4thed.Geneva:InternationalUnionAgainstCancer（UICC）,1987:130-2.
6KossowJH,HotchkissAS,MoralesPA:Carcinomaofthepenistreatedsurgically:Analysisof100cases.Urology1973;2:169.
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11.MazeronJJ,LangloisD,LoboPA,etal:Interstitialradiationtherapyforcarcinomaofthepenisusingiridium192wires:theHenriMondorexperience（1970-1979）
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14.SklaroffRB,YagodaA:Cis-DiaminedichlorideplatinumII（DDP）inthetreatmentofpenilecarcinoma.Cancer1979;44:1563-5.
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17.IchikawaT,NakanoI,HirokawaI:Bleomycintreatmentofthetumorsofpenisandscrotum.JUrol1969;102:699-707.
18.KylwaziSK,BhamsD,HarrisonNWW:CarcinomaofthepenisandbleomycinchemotherapyinUganda.BrJUrol1974;46:689-96.
19.xj洛|f菌砾gnOp舱戈A1976-1995C
瓜1-1xWa跋潮掺のㄤLk┦ネ崔竟x砾gC~E_H计（F|矫ネp参p戈）C
瓜1-2xWa跋潮掺砾ぇof~闹だG瓜（F|矫ネp参p戈）C
瓜2-1iゅんf（Bowenˉsdisease）A@贺キ灿M砾（squamouscellcarcinoma）砾C
瓜2-2潮掺キ灿M砾CbYà借て（keratinization）场C
瓜2-3潮掺砾C~FDntYB环狠]ブの潮掺FC
瓜7-1xj洛|Ν戳の边戳潮掺砾fHぇspゑ耕（Kaplan-Meierplot）CㄢsfHぇs戳Τ陪参pWぇt钵（Log-ranktest）C
