Simone Christine G, Zuluaga Toro Tania, Chan Ellie, Feely Michael M, Trevino Jose G, George Thomas J
Division of Hematology and Oncology Department of Medicine.
Gastrointest Cancer Res. 2013 May;6(3):75-9.
Adenosquamous carcinoma of the pancreas (ASCAP) is a rare histologic type of pancreatic carcinoma that constitutes 1% to 4% of all pancreatic exocrine malignancies. It has a clinical presentation similar to that of adenocarcinoma of the pancreas (ACP), but may have a worse overall prognosis, with most patients surviving for less than 2 years.
This was an institutional, retrospective, cohort analysis of 237 patients who underwent resection of pancreatic cancer with curative intent.
Of the 237 cases examined, we identified 7 (2.9%) with histologically confirmed ASCAP. Demographics, comorbidities, risk factors, presenting symptoms, survival data, tumor characteristics, and types of treatment for each patient were included in the analysis. Risk factors for development of ASCAP were not conclusive. Although human papilloma virus (HPV) has been implicated in other squamous cell cancers, in our cohort, its involvement in ASCAP was 0%. Presurgical fine-needle aspiration failed to identify the invasive squamous cell component in all cases. In this cohort analysis, overall survival ranged from 3 to 25 months, with 2 patients surviving more than 20 months after surgical resection. With a median follow-up of 2.9 years, our data demonstrate a trend to worse median overall survival for ASCAP than for ACP (8.2 vs. 20.4 months; P = .23), with a limited number of long-term survivors.
Although recommended, adjuvant treatment was inconsistently provided for patients in this ASCAP cohort. Published data show variability in overall survival, but our findings support that surgical resection is one of the few options for control of this rare, poorly understood pancreatic malignancy. Further research is necessary to define risk factors and adjuvant and neoadjuvant treatments, to help improve patient outcomes.
胰腺腺鳞癌（ASCAP）是一种罕见的胰腺癌组织学类型，占所有胰腺外分泌恶性肿瘤的1%至4%。其临床表现与胰腺腺癌（ACP）相似，但总体预后可能更差，大多数患者生存期不足2年。
这是一项对237例接受根治性胰腺癌切除术患者的机构性回顾性队列分析。
在237例检查病例中，我们确定了7例（2.9%）经组织学确诊为ASCAP。分析纳入了每位患者的人口统计学、合并症、危险因素、症状表现、生存数据、肿瘤特征及治疗类型。ASCAP发生的危险因素尚无定论。尽管人乳头瘤病毒（HPV）与其他鳞状细胞癌有关，但在我们的队列中，其在ASCAP中的参与率为0%。所有病例的术前细针穿刺均未能识别出浸润性鳞状细胞成分。在此队列分析中，总生存期为3至25个月，2例患者术后生存超过20个月。中位随访2.9年，我们的数据显示ASCAP的中位总生存期有比ACP更差的趋势（8.2个月对20.4个月；P = 0.23），长期幸存者数量有限。
尽管推荐进行辅助治疗，但该ASCAP队列中的患者接受辅助治疗的情况并不一致。已发表的数据显示总生存期存在差异，但我们的研究结果支持手术切除是控制这种罕见且了解甚少的胰腺恶性肿瘤的少数选择之一。有必要进一步研究以确定危险因素以及辅助和新辅助治疗方法，以帮助改善患者预后。
