Komatsu Hirotake, Egawa Shinichi, Motoi Fuyuhiko, Morikawa Takanori, Sakata Naoaki, Naitoh Takeshi, Katayose Yu, Ishida Kazuyuki, Unno Michiaki
Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Surg Today. 2015 Mar;45(3):297-304. doi: 10.1007/s00595-014-0934-0. Epub 2014 Jun 29.
Adenosquamous carcinoma of the pancreas is a rare subtype of pancreatic cancer. We herein describe the clinicopathological features of surgically resected cases of adenosquamous carcinoma of the pancreas.
From 2001 to 2011, 132 patients underwent R0 resection for Stage IIA or IIB pancreatic cancer. The survival rate, pathological features and recurrence status were reviewed.
Out of 132 patients, 121 patients had tubular adenocarcinoma, and only seven had adenosquamous carcinoma (ASC). The incidence of ASC increased with the tumor size. The overall survival and disease-free survival periods of the patients with ASC were significantly shorter than those of patients with tubular adenocarcinoma (p = 0.0153 and p = 0.0045). The histological findings revealed more marked venous invasion in ASC compared to tubular adenocarcinoma (G1, G2 and G3). The proportion of v3 cases, which denotes the most severe venous invasion, was 31.3 % in G1, 47.3 % in G2, 60.0 % in G3 and 71.4 % in ASC cases, respectively. Other factors, including lymphatic and nerve invasion, were not correlated with the histological subtypes. The incidence of ASC was 11.1 % in the tumors more than 6 cm in diameter, and 0 % in those less than 2 cm in diameter.
We revealed that adenosquamous carcinoma of the pancreas is associated with a poor outcome, and also clarified its clinicopathological features.
胰腺腺鳞癌是胰腺癌的一种罕见亚型。我们在此描述手术切除的胰腺腺鳞癌病例的临床病理特征。
2001年至2011年，132例患者接受了IIA期或IIB期胰腺癌的R0切除。回顾了生存率、病理特征和复发情况。
132例患者中，121例患有管状腺癌，仅7例患有腺鳞癌（ASC）。ASC的发病率随肿瘤大小增加而升高。ASC患者的总生存期和无病生存期明显短于管状腺癌患者（p = 0.0153和p = 0.0045）。组织学检查发现，与管状腺癌（G1、G2和G3）相比，ASC中的静脉侵犯更为明显。表示最严重静脉侵犯的v3病例比例在G1中为31.3%，在G2中为47.3%，在G3中为60.0%，在ASC病例中为71.4%。包括淋巴和神经侵犯在内的其他因素与组织学亚型无关。直径大于6 cm的肿瘤中ASC的发病率为11.1%，直径小于2 cm的肿瘤中ASC的发病率为0%。
我们发现胰腺腺鳞癌与不良预后相关，并阐明了其临床病理特征。
