肛管癌病理学

Pathology of Anal Cancer.

作者信息

Hoff Paulo M, Coudry Renata, Moniz Camila Motta Venchiarutti

机构信息

Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo 01246 000, Brazil.

Hospital Sírio Libânes, Rua Dona Adma Jafet, 115 - Bela Vista, São Paulo, São Paulo 01308 050, Brasil.

出版信息

Surg Oncol Clin N Am. 2017 Jan;26(1):57-71. doi: 10.1016/j.soc.2016.07.013.

DOI:10.1016/j.soc.2016.07.013

PMID:27889037

Abstract

Anal canal cancer is rather an uncommon disease but its incidence is increasing. Squamous cell carcinoma (SCC) is the most frequent primary anal neoplasm and can encompass a variety of morphologies. HPV infection has a key role in precancerous lesions and cancer development by the production of E6 and E7 oncoproteins. Anal squamous precancerous lesions are now classified according to the same criteria and terminology as their cervical counterparts. The p16 expression by immunohistochemistry is a surrogate marker for human papilloma virus (HPV). Many other tumor types can arise in the anal canal, including adenocarcinomas, neuroendocrine tumors, malignant melanomas, lymphomas and various types of mesenchymal tumors. For differential diagnosis, immunostaining markers such as CK5/6 and p63 can be used to distinguish SCC and CK7 for adenocarcinoma. Other classical panels can also be applied as in other locations. Currently, there are no biomarkers able to predict prognosis or response to treatment in clinical practice.

摘要

肛管癌是一种相当罕见的疾病，但其发病率正在上升。鳞状细胞癌（SCC）是最常见的原发性肛管肿瘤，可呈现多种形态。人乳头瘤病毒（HPV）感染通过产生E6和E7癌蛋白在癌前病变和癌症发展中起关键作用。肛管鳞状癌前病变现在根据与宫颈同类病变相同的标准和术语进行分类。免疫组织化学检测p16表达是人乳头瘤病毒（HPV）的替代标志物。肛管还可出现许多其他肿瘤类型，包括腺癌、神经内分泌肿瘤、恶性黑色素瘤、淋巴瘤和各种间叶性肿瘤。为进行鉴别诊断，免疫染色标志物如CK5/6和p63可用于鉴别SCC，CK7用于鉴别腺癌。其他经典的免疫组化组合也可像在其他部位一样应用。目前，在临床实践中尚无能够预测预后或治疗反应的生物标志物。