口腔鳞状细胞癌放疗后肉瘤及肉瘤样肿瘤：4例分析

Sarcomas and sarcomatoid tumor after radiotherapy of oral squamous cell carcinoma: analysis of 4 cases.

作者信息

Chen Ya-Wei, Tu Hsi-Fen, Wu Tsen-Hsian, Lo Wen-Liang, Chang Che-Shoa, Chang Kuo-Wei, Kao Shou-Yen

机构信息

Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Veterans General Hospital (Taipei VGH), School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jan;105(1):65-71. doi: 10.1016/j.tripleo.2007.01.035. Epub 2007 May 15.

DOI:10.1016/j.tripleo.2007.01.035

PMID:17507260

Abstract

Radiation-induced sarcoma (RIS) or postirradiation sarcoma has been reported rarely as a long-term complication of radiation therapy (RT). We report 4 cases of oral sarcomas or sarcomatoid tumors with a rather short latency period after radiotherapy of the prior OSCC. Histopathological evaluation and immunohistochemical study were performed using a panel of markers including vimentin, cytokeratin, S-100, desmin, myoglobin, HHF-35, p53, and p16. All reported cases were positive for vimentin and negative for cytokeratin. Two cases were positive for myoglobin, desmin, or HHF-35, and were probably myogenic origin. One case was possibly a fibrosarcoma and the subclassification of the other one was not specified. Diverse expression of p53 and p16 was further observed in these 4 cases. Report of the complicated clinical processes and the analysis of genetic markers of these cases provide useful clinical and pathogenetic insights of mesenchymal malignancies associated with a status post OSCC radiation.

摘要

放射诱导性肉瘤（RIS）或放疗后肉瘤作为放射治疗（RT）的一种长期并发症鲜有报道。我们报告了4例口腔肉瘤或肉瘤样肿瘤病例，这些病例在先前口腔鳞状细胞癌（OSCC）放疗后潜伏期相对较短。使用包括波形蛋白、细胞角蛋白、S-100、结蛋白、肌红蛋白、HHF-35、p53和p16在内的一组标志物进行了组织病理学评估和免疫组化研究。所有报告病例波形蛋白呈阳性，细胞角蛋白呈阴性。2例肌红蛋白、结蛋白或HHF-35呈阳性，可能起源于肌源性。1例可能为纤维肉瘤，另一例未明确亚型分类。在这4例病例中还进一步观察到p53和p16的不同表达。这些病例复杂临床过程的报告以及遗传标志物分析为与OSCC放疗后状态相关的间叶性恶性肿瘤提供了有用的临床和发病机制见解。