Patel Kalyani R, Chernock Rebecca D, Sinha Parul, Müller Susan, El-Mofty Samir K, Lewis James S
Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St. Louis, MO, 63110, USA.
Head Neck Pathol. 2015 Mar;9(1):65-73. doi: 10.1007/s12105-014-0551-7. Epub 2014 Jun 20.
Verrucous carcinomas (VC) recur locally but do not metastasize in the absence of an invasive squamous cell carcinoma (SCC) component. Although excluded from the definition of pure VC, some tumors harbor only dysplasia or minimal invasion, findings of unknown clinical significance. Surgically resected VC cases from two institutions were collected and categorized into three types: VC, VC with dysplasia or minimal invasion (VCDMI), defined as SCC less than or equal to 2 mm in depth, and SCC arising in VC (SCC-VC) where the SCC was greater than 2 mm in depth. Cases were also matched with conventional SCC based on location and T and N-stages, and clinical follow up was obtained. Of the 58 total cases, 18 were VC, 26 VCDMI, and 14 SCC-VC. Only 1 of 18 (5.6 %) VC and 5 of 26 (19.2 %) VCDMI cases recurred locally (p = 0.37) versus 7 of 14 (50 %) SCC-VC (p = 0.01). All VC and VCDMI cases were node negative at presentation whereas SCC-VC had nodal metastases in 2 of 14 (14.3 %) cases. No patients with VC or VCDMI died from disease, whereas 5 of 14 (35.7 %) patients with SCC-VC died from disease. T-stage matched conventional SCC cases from institutional databases had worse outcomes than VC and VCDMI, but not after they were matched for both T and N-stages. Our findings suggest that dysplasia and/or minimal invasive SCC do not adversely affect outcomes in tumors otherwise showing diagnostic features of VC.
疣状癌（VC）虽可局部复发，但在无浸润性鳞状细胞癌（SCC）成分时不会发生转移。尽管某些肿瘤仅伴有发育异常或微浸润，这些发现的临床意义尚不明确，但它们被排除在纯VC的定义之外。收集了来自两家机构的手术切除的VC病例，并将其分为三种类型：VC、伴有发育异常或微浸润的VC（VCDMI，定义为深度小于或等于2mm的SCC）以及VC中发生的SCC（SCC-VC，其中SCC深度大于2mm）。病例还根据位置以及T和N分期与传统SCC进行匹配，并获得了临床随访结果。在总共58例病例中，18例为VC，26例为VCDMI，14例为SCC-VC。18例VC中仅1例（5.6%）和26例VCDMI中的5例（19.2%）出现局部复发（p = 0.37），而14例SCC-VC中有7例（50%）复发（p = 0.01）。所有VC和VCDMI病例在初诊时均无淋巴结转移，而14例SCC-VC中有2例（14.3%）出现淋巴结转移。没有VC或VCDMI患者死于该疾病，而14例SCC-VC患者中有5例（35.7%）死于该疾病。来自机构数据库的T分期匹配的传统SCC病例的预后比VC和VCDMI差，但在T和N分期均匹配后则不然。我们的研究结果表明，发育异常和/或微浸润性SCC不会对其他方面表现出VC诊断特征的肿瘤的预后产生不利影响。
