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Basaloid Squamous Cell Carcinoma of the Anus Revisited.

肛门基底细胞样鳞状细胞癌的回顾性分析

Graham RP,Arnold CA,Naini BV,Lam-Himlin DM

Abstract

Basaloid squamous cell carcinoma (SCC) of the anus, previously called cloacogenic carcinoma, is a subtype of SCC. There are very few data on the morphologic variation within basaloid SCC of the anus, which may contribute to misdiagnosis. We retrospectively evaluated cases originally diagnosed as basaloid SCC for histologic characterization. We retrieved and reviewed cases of basaloid SCC from 1994 to 2013. Ten (27%) cases were reclassified after review, including basal cell carcinoma (n=6), melanoma (n=2), and neuroendocrine carcinoma (n=2). The final group of basaloid SCC (n=27) showed a female predominance (median age=60 y; range, 42 to 92 y). Morphologically, basaloid SCC could be categorized into 4 groups: transitional carcinoma like (n=10), basaloid with peripheral palisade (n=13), adenoid cystic carcinoma like (n=3), and mucinous microcystic (n=1). In 19 cases the histologic patterns were pure and were mixed in the remainder. CK5/6, p16, and high-risk HPV were positive in all cases (n=27). SOX2 was positive in 18/22 cases. Clinical follow-up was available on 60% of cases; 9 patients (53%) developed local recurrence or metastasis, and 5 (29%) died of disease. Basaloid SCC of the anus is characterized by 4 major histologic patterns and is consistently HPV driven.

摘要

肛门的基底细胞样鳞癌以往被称为泄殖腔癌,是鳞癌的一种亚型。有关肛门基底细胞样鳞癌形态学差异的数据资料很少,所以容易导致误诊。我们回顾性分析了以往诊断为具有基底细胞样鳞癌组织学特点的病例,收集并复习了1994-2013年的基底细胞样鳞癌的病例。其中10例(27%)重新分类为基底细胞癌(n=6)、恶性黑色素瘤(n=2)、神经内分泌癌(n=2)。最后确诊为基底细胞样鳞癌的病例(n=27)中女性患者占优势(中位年龄为60岁,年龄范围从42-92岁)。形态学上,基底细胞样鳞癌可以分为4组:移行细胞癌样(n=10),周边呈栅栏状的基底细胞样(n=13),囊腺癌样(n=3),粘液微囊状(n=10)。19例组织学表现单一,其余则为混合性。所有基底细胞样鳞癌病例(n=27)CK5/6、p16和高危HPV均为阳性,SOX2阳性为18/22。60%的病例有临床随访;9例(53%)患者复发或远处转移,5例(29%)死亡。肛门基底细胞样鳞癌有四种组织学形式并且与HPV持续感染相关。

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