Cho K J, Jang J J, Lee S S, Zo J I
Departments of Anatomic Pathology; Thoracic Surgery, Korea Cancer Center Hospital, Seoul, Korea.
Histopathology. 2000 Apr;36(4):331-40. doi: 10.1046/j.1365-2559.2000.00851.x.
Basaloid squamous carcinoma (BSC) is an uncommon variant of squamous cell carcinoma, with its prevalent sites being the hypopharynx, tongue base and larynx. In the oesophagus, BSC is rarer than in the head and neck region. This study was aimed to document the clinicopathological features of BSCs of the oesophagus, and to present their relative incidence and immunohistochemical findings.
Eighteen cases of BSC of the oesophagus, comprising 3.6% of 502 oesophageal carcinomas, were reviewed for their pathological and clinical features, and examined for the immunohistochemical expression of neuroendocrine markers, cytokeratins, p53, pRb and bcl-2. Oesophageal basaloid squamous carcinomas tended to be biphasic or multiphasic carcinomas, most commonly with basaloid and squamous components (eight cases), or with additional adenocarcinoma (three cases) or with small cell carcinoma (two cases). Each component was microscopically clearly distinguishable from the others, and metastasized separately, chiefly the basaloid component. The remaining five cases were apparently pure basaloid carcinomas, being characterized by lobules and nests of monotonous round undifferentiated cells with frequent comedo necrosis. They resembled, but were differentiated from, the small cell carcinoma on the basis of neuroendocrine markers and cytokeratin expression. p53, pRb and bcl-2 oncoprotein, which are known to normally present in the basal/parabasal cells of the oesophageal epithelium, were detected in 40-50% of cases, with a heterogeneous expression pattern. The patients were all male, with the age ranging 47-74 years (median 57) and presented at variable stages. The plotted 3 years survival rate was 51%, and the immunohistochemical expression of p53, pRb and bcl-2 was not related to the survival of the patients.
Basaloid squamous carcinoma of the oesophagus is a peculiar neoplasm with a capacity of multidirectional differentiation, often with heterogeneous oncogene expression, probably reflecting the pluripotential stem cell origin.
基底样鳞状细胞癌（BSC）是鳞状细胞癌的一种罕见变体，其常见部位为下咽、舌根和喉部。在食管中，BSC比在头颈部区域更为罕见。本研究旨在记录食管BSC的临床病理特征，并呈现其相对发病率和免疫组化结果。
对18例食管BSC进行回顾性分析，这些病例占502例食管癌的3.6%，分析其病理和临床特征，并检测神经内分泌标志物、细胞角蛋白、p53、pRb和bcl-2的免疫组化表达。食管基底样鳞状细胞癌倾向于为双相或多相癌，最常见的是具有基底样和鳞状成分（8例），或伴有额外的腺癌（3例）或小细胞癌（2例）。每个成分在显微镜下均可清晰地与其他成分区分，且分别转移，主要是基底样成分转移。其余5例显然为纯基底样癌，其特征为小叶状和巢状排列的单一圆形未分化细胞，常伴有粉刺样坏死。根据神经内分泌标志物和细胞角蛋白表达，它们与小细胞癌相似但又有区别。已知正常存在于食管上皮基底/副基底细胞中的p53、pRb和bcl-2癌蛋白在40% - 50%的病例中被检测到，表达模式不均一。患者均为男性，年龄在47 - 74岁之间（中位年龄57岁），就诊时处于不同分期。绘制的3年生存率为51%，p53、pRb和bcl-2的免疫组化表达与患者的生存率无关。
食管基底样鳞状细胞癌是一种具有多向分化能力的特殊肿瘤，常伴有不均一的癌基因表达，可能反映了其多能干细胞起源。
