Zoppi J, Avagnina A, Elsner B, Terzian A, Kaimen M
Departamento de Patología, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 1991;51(3):222-6.
A clinico-pathological and immunohistochemical study of 22 cases of undifferentiated carcinoma (UC) of the nose and paranasal sinuses is presented. There were 6 nasal and 16 sinusal lesions. Eleven were small cell, 7 of the intermediate type and 4 of the large cell type. All the large cell UC originated in the sinuses. Immunohistochemically all but three of the UC (all small cell) were positive for an epithelial marker. EMA was better in this study than cytokeratin and CEA (19, 14 and 8 positive cases). Neuroendocrine markers were positive in 5 cases of the large cell UC (Table I). Of the 18 cases with follow up, 3 patients died of their tumor, 9 were alive with disease and 5 were with no evidence of disease after an average of 36 months. Patients with UC of the intermediate variant and large cell type had a better prognosis than those of the small cell type (Table 2). Cases treated with surgery and radiation therapy with or without chemotherapy had a better prognosis than those treated with either one of those treatments alone. This study shows that many of the UC of the nose and sinuses have a neuroendocrine phenotype and although they are aggressive neoplasms they seem to be not as lethal as suggested in the literature.
本文呈现了一项对22例鼻腔及鼻窦未分化癌（UC）的临床病理及免疫组织化学研究。其中有6例鼻腔病变和16例鼻窦病变。11例为小细胞型，7例为中间型，4例为大细胞型。所有大细胞型UC均起源于鼻窦。免疫组织化学检测显示，除3例UC（均为小细胞型）外，其余所有病例的上皮标志物均呈阳性。在本研究中，上皮膜抗原（EMA）的阳性表现优于细胞角蛋白和癌胚抗原（分别为19例、14例和8例阳性）。5例大细胞型UC的神经内分泌标志物呈阳性（表I）。在18例有随访记录的病例中，3例患者死于肿瘤，9例带瘤生存，5例在平均36个月后无疾病证据。中间型和大细胞型UC患者的预后优于小细胞型UC患者（表2）。接受手术及放疗加或不加化疗的病例，其预后优于仅接受其中一种治疗的病例。本研究表明，许多鼻腔及鼻窦UC具有神经内分泌表型，尽管它们是侵袭性肿瘤，但似乎并不像文献中所提示的那样致命。
