Kusafuka Kimihde, Ebihara Mitsuru, Ishiki Hiroto, Takizawa Yoshinori, Iida Yoshiyuki, Onitsuka Tetsuro, Takakuwa Reiko, Kasami Masako, Ito Ichiro, Kameya Toru
Division of Pathology, Shizuoka Cancer Center, Sunto, Shizoaka, Japan.
Pathol Int. 2006 Feb;56(2):78-83. doi: 10.1111/j.1440-1827.2006.01927.x.
Adenoid squamous cell carcinoma (ASCC) is an uncommon but well-recognized variant of squamous cell carcinoma that was first described by Lever in 1947. ASCC has been reported to originate in the sun-exposed skin of the head and neck and in other sites. An additional case of ASCC is reported here. The patient was a 64-year-old Japanese woman who requested examination of a reddish lesion on the left floor of the mouth. The biopsy material was diagnosed as squamous cell carcinoma. Clinical examination showed a well-circumscribed, 20 x 10 mm-sized lesion, which was categorized as cT2cN0cm 0. Tumor resection was therefore performed. Histologically, most parts of the lesion were conventional squamous cell carcinoma in situ, but the invasive part consisted of ASCC with gland-like or reticular appearance. The latter part was negative for mucin staining. Immunohistochemically, this lesion was positive for pancytokeratin, high-molecular-weight keratin, cytokeratin (CK) 7/8, CK19, E-cadherin and p53, but negative for vimentin, CK20, and S-100 protein. The Ki-67 labeling index was 50.3% in the ASCC part and 34.5% in the carcinoma in situ part. These findings and a review of the literature indicate that a gland-like feature of ASCC is associated with the loss of cell adhesion in the center of the cancer nests, and it can be confirmed simply by mucin staining to be neither an adenosquamous carcinoma nor ductal involvement of conventional squamous cell carcinoma.
腺样鳞状细胞癌（ASCC）是一种罕见但已被充分认识的鳞状细胞癌变体，于1947年由利弗首次描述。据报道，ASCC起源于头颈部暴露于阳光下的皮肤以及其他部位。本文报告了另外一例ASCC病例。患者为一名64岁的日本女性，因左侧口腔底部出现红色病变而要求检查。活检材料被诊断为鳞状细胞癌。临床检查显示一个边界清晰、大小为20×10毫米的病变，分类为cT2cN0cm 0。因此进行了肿瘤切除。组织学上，病变的大部分为原位常规鳞状细胞癌，但浸润部分由具有腺样或网状外观的ASCC组成。后一部分黏液染色为阴性。免疫组化方面，该病变对全细胞角蛋白、高分子量角蛋白、细胞角蛋白（CK）7/8、CK19、E-钙黏蛋白和p53呈阳性，但对波形蛋白、CK20和S-100蛋白呈阴性。在ASCC部分，Ki-67标记指数为50.3%，在原位癌部分为34.5%。这些发现以及文献回顾表明，ASCC的腺样特征与癌巢中心细胞黏附丧失有关，并且通过黏液染色可以简单确认其既不是腺鳞癌也不是常规鳞状细胞癌的导管侵犯。
