头颈部梭形细胞鳞状细胞癌20例临床病理特征分析

韩铭 徐梦微 石力 王映梅 刘一雄 徐婉妮 徐玉乔

韩铭, 徐梦微, 石力, 王映梅, 刘一雄, 徐婉妮, 徐玉乔. 头颈部梭形细胞鳞状细胞癌20例临床病理特征分析[J]. 中国肿瘤临床, 2023, 50(22): 1147-1152. doi: 10.12354/j.issn.1000-8179.2023.20230923
引用本文: 韩铭, 徐梦微, 石力, 王映梅, 刘一雄, 徐婉妮, 徐玉乔. 头颈部梭形细胞鳞状细胞癌20例临床病理特征分析[J]. 中国肿瘤临床, 2023, 50(22): 1147-1152. doi: 10.12354/j.issn.1000-8179.2023.20230923
Ming Han, Mengwei Xu, Li Shi, Yingmei Wang, Yixiong Liu, Wanni Xu, Yuqiao Xu. Clinicopathological characteristics analysis of 20 cases of head and neck spindle cell squamous cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(22): 1147-1152. doi: 10.12354/j.issn.1000-8179.2023.20230923
Citation: Ming Han, Mengwei Xu, Li Shi, Yingmei Wang, Yixiong Liu, Wanni Xu, Yuqiao Xu. Clinicopathological characteristics analysis of 20 cases of head and neck spindle cell squamous cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(22): 1147-1152. doi: 10.12354/j.issn.1000-8179.2023.20230923

头颈部梭形细胞鳞状细胞癌20例临床病理特征分析

doi: 10.12354/j.issn.1000-8179.2023.20230923
详细信息
    作者简介:

    韩铭:专业方向为头颈及乳腺临床病理研究

    通讯作者:

    徐玉乔 yuqiaoxu@fmmu.edu.cn

Clinicopathological characteristics analysis of 20 cases of head and neck spindle cell squamous cell carcinoma

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  • 摘要:   目的  探讨头颈部梭形细胞鳞状细胞癌(spindle cell squamous cell carcinoma,SCSCC)的临床病理特征、免疫表型及其预后,以提高对该肿瘤的认识及诊断水平。  方法  回顾性分析2012年1月至2022年12月空军军医大学第一附属医院20例头颈部SCSCC患者的临床病理资料,观察其组织学形态、免疫表型,采用原位杂交法检测EBER表达情况,荧光原位杂交法检测MDM2基因扩增情况。  结果  20例头颈部SCSCC患者男女比例4∶1,中位年龄67岁。以喉部(35.0%)及鼻腔鼻窦(30.0%)最为多见。息肉状或外生性生长及表面溃疡分别见于61.5%及90.0%的患者。组织学特征方面,15例(75.0%)显示肉瘤样生长方式,其余可见肉芽组织样及血管肉瘤样生长。65.0%肿瘤含有普通型鳞状细胞癌成分,以高-中分化鳞状细胞癌最为常见(91.7%)。免疫组织化学方面,83.3%(15/18)患者表达AE1/AE3, p63及p40表达率分别为62.5%、66.7%。所有患者EBER均为阴性。Ki-67增殖指数范围10%~70%。33.3%(1/3)患者呈现MDM2基因扩增。18例患者中位随访时间18.3(1~92)个月,其中6例生存,12例死亡。  结论  头颈部SCSCC多见于老年吸烟男性,以息肉状生长为主,无HPV及EBV感染,确诊需综合临床、病理特征及免疫表型,手术切除为其主要治疗方法。

     

  • 图  1  电子鼻咽喉镜示左侧声带中后方可见肿物生长,累及左侧室带后端

    图  2  低倍镜示肿物呈外生性生长,表面可见炎性渗出坏死(H&E×20)

    图  3  肿瘤细胞呈梭形致密排列,细胞染色质深染,核分裂象易见(H&E×200)

    图  4  肿瘤细胞呈裂隙样分布,似血管肉瘤样(H&E×200)

    图  5  肿瘤细胞伴异源性横纹肌母细胞分化(H&E×200)

    图  6  FISH检测:MDM2基因扩增

    表  1  20例头颈部SCSCC患者临床资料

    序号 性别 年龄(岁) 发生部位 肿块大小(cm) 临床分期 随访(月) 预后 放疗 复发 远处转移
    1 66 左侧外耳道 3.0 32.5 无病生存
    2 90 左侧鼻腔鼻窦 6.0 20.0 死亡
    3 75 右侧颊部 3.1 92.0 死亡
    4 60 左声带及前联合 2.0 18.5 无病生存
    5 77 右侧声带 1.0 6.5 死亡
    6 67 左侧声带 0.7 13.5 无病生存
    7 79 左侧扁桃体 2.5 3.0 死亡 腹壁转移
    8 82 左侧声带 0.6 5.0 无病生存
    9 61 下咽侧壁 1.5 22.5 死亡 术后13个月 肺转移
    10 78 左侧咽部 4.5 18.0 死亡 肺转移
    11 70 左上颌窦 5.0 4.0 死亡
    12 68 声门区 3.7 1.0 死亡
    13 66 右侧声带 2.0 65.0 带瘤生存 肺转移
    14 51 右侧咽部及舌根 2.5 NS
    15 60 左侧鼻腔 5.0 6.5 死亡
    16 71 左侧鼻腔 1.5 NS
    17 59 右侧鼻腔鼻窦、鼻咽、翼颚窝 6.5 21.5 死亡
    18 57 左侧上颌窦 4.5 35.0 死亡 术后31个月
    19 32 3.0 41.0 带瘤生存 术后41个月
    20 67 声门区 1.8 9.0 死亡
    NS:失访
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  • [1] Prieto-Granada CN, Xu B, Alzumaili B, et al. Clinicopathologic features and outcome of head and neck mucosal spindle cell squamous cell carcinoma[J]. Virchows Arch, 2021, 479(4):729-739. doi: 10.1007/s00428-021-03117-2
    [2] Zidar N, Gale N. Update from the 5th edition of the World Health Organization classification of head and neck tumors: hypopharynx, larynx, Trachea and parapharyngeal space[J]. Head Neck Pathol, 2022, 16(1):31-39. doi: 10.1007/s12105-021-01405-6
    [3] Lin MC, Hsu CL, Lai SF, et al. Spindle cell carcinoma of the head and neck: clinical characteristics and molecular signatures[J]. Laryngoscope, 2023, 133(9):2183-2191. doi: 10.1002/lary.30467
    [4] Baumeister P, Zhou JF, Canis M, et al. Epithelial-to-mesenchymal transition-derived heterogeneity in head and neck squamous cell carcinomas[J]. Cancers (Basel), 2021, 13(21):5355. doi: 10.3390/cancers13215355
    [5] Neha B, Shashi D, Seema R. Spindle cell squamous cell carcinoma of head and neck region: a clinicopathological and immunohistochemical study[J]. Indian J Surg Oncol, 2021, 12(4):699-705. doi: 10.1007/s13193-021-01418-1
    [6] Bishop JA, Montgomery EA, Westra WH. Use of p40 and p63 immunohistochemistry and human papillomavirus testing as ancillary tools for the recognition of head and neck sarcomatoid carcinoma and its distinction from benign and malignant mesenchymal processes[J]. Am J Surg Pathol, 2014, 38(2):257-264. doi: 10.1097/PAS.0000000000000119
    [7] Xu B, Suurmeijer AJH, Agaram NP, et al. Head and neck rhabdomyosarcoma with TFCP2 fusions and ALK overexpression: a clinicopathological and molecular analysis of 11 cases[J]. Histopathology, 2021, 79(3):347-357. doi: 10.1111/his.14323
    [8] Quan HZ, Sreekissoon S, Wang Y. Synovial sarcoma of the head and neck: a review of reported cases on the clinical characteristics and treatment methods[J]. Front Cell Dev Biol, 2022, 10:1077756.
    [9] Zheng JL, Miao FL, Wang Z, et al. Identification of MDM2 as a prognostic and immunotherapeutic biomarker in a comprehensive pan-cancer analysis: a promising target for breast cancer, bladder cancer and ovarian cancer immunotherapy[J]. Life Sci, 2023, 327:121832. doi: 10.1016/j.lfs.2023.121832
    [10] Hou HL, Sun DT, Zhang XC. The role of MDM2 amplification and overexpression in therapeutic resistance of malignant tumors[J]. Cancer Cell Int, 2019, 19:216. doi: 10.1186/s12935-019-0937-4
    [11] Chrysovergis A, Papanikolaou V, Tsiambas E, et al. P53/MDM2 Co-expression in laryngeal squamous cell carcinoma based on digital image analysis[J]. Anticancer Res, 2019, 39(8):4137-4142. doi: 10.21873/anticanres.13572
    [12] Bice TC, Tran V, Merkley MA, et al. Disease-specific survival with spindle cell carcinoma of the head and neck[J]. Otolaryngol Head Neck Surg, 2015, 153(6):973-980.
    [13] Patel AM, Choudhry HS, Desai AD, et al. Prognostic significance of head and neck spindle cell carcinoma[J]. Head Neck, 2023, 45(3):685-696. doi: 10.1002/hed.27285
    [14] Ding L, Bi ZF, Yuan H, et al. Sarcomatoid carcinoma in the head and neck: a population-based analysis of outcome and survival[J]. Laryngoscope, 2021, 131(2):E489-E499.
    [15] Mingo KM, Derakhshan A, Abdullah N, et al. Characteristics and outcomes in head and neck sarcomatoid squamous cell carcinoma: the cleveland clinic experience[J]. Ann Otol Rhinol Laryngol, 2021, 130(7):818-824. doi: 10.1177/0003489420977778
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出版历程
  • 收稿日期:  2023-09-19
  • 录用日期:  2023-11-29
  • 修回日期:  2023-11-29

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