摘要目的：探讨良、恶性汗孔分化肿瘤的临床病理特征和鉴别诊断。方法对35例汗孔瘤和10例汗孔癌的病例进行临床病理特征回顾性分析。结果35例汗孔瘤患者平均年龄48岁，10例汗孔癌患者平均年龄65岁。良性和恶性汗孔瘤的发病部位相似，以头面部和四肢最为常见。良性汗孔瘤组织学亚型依次为经典型（23例）、真皮导管瘤（9例）和单纯性汗腺棘皮瘤（3例）。所有的汗孔癌都伴有残存的良性汗孔瘤成分，以经典型为主，但是在其他区域瘤细胞显示显著的异型性和／或间质浸润。结论汗孔分化肿瘤的正确诊断主要依靠病理组织学观察，肿瘤细胞异型性和／或浸润性生长方式是汗孔瘤与汗孔癌鉴别的重要依据，局灶高分裂活性和灶状肿瘤细胞坏死不能作为汗孔癌的独立诊断指标，病史较长的汗孔瘤如近期快速生长多提示有恶变。

abstractsObjective To investigate the clinicopathological features and the differential diagnosis of poroma and porocarcinoma.Methods Histopathological characteristics and clinical data of 35 cases of poroma and 10 cases of porocarcinoma were analyzed retrospectively.Results The average age of 35 patients of poroma was 48 years.The average age of 10 patients of porocarcinoma was 65 years.Both poroma and porocarcinoma occured most frequently on the scalp and face,as well as the extremities.Histologically, cases of poroma were divided into three subtypes, including classic poroma (23 cases), hidroacanthoma simplex (3 cases) and dermal duct tumor (9 cases).Residual foci of benign poroma were found in all cases of porocarcinoma, most of which were classic poroma.The malignant components showed severe dysplasia and/or stromal infiltration.Conclusion The diagnosis of poroma and porocarcinoma is mainly based on the microscopic characteristics.An invasive architectural pattern and/or significant cytologic pleomorphism are the most important clues for the diagnosis of porocarcinoma.Neither focal mitotic activity nor the presence of necrosis was the diagnostic feature of porocarcinoma.Malignant transformation can occur in some cases of long existing poroma with recent, rapid tumor enlargement.