Lobo Brian C, D'Anza Brian, Farlow Janice L, Tang Dennis, Woodard Troy D, Ting Jonathan Y, Sindwani Raj
Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Am J Rhinol Allergy. 2017 Sep 1;31(5):305-309. doi: 10.2500/ajra.2017.31.4470.
Sinonasal squamous cell carcinoma (SCC) accounts for <1% of all malignancies but represents 70% of sinonasal cancer. Up to 10% of SCCs are associated with inverted papilloma (IPSCC). Studies that compare patients, treatment, and outcomes of SCC and IPSCC are absent in the literature.
A retrospective review of patients with SCC and those with IPSCC at Cleveland Clinic and Indiana University from 1995 to 2015. The records were analyzed for demographics, tumor characteristics, treatment, and outcomes.
The study comprised 117 patients with SCC, of whom, 29 had IPSCC. The mean age at diagnosis was similar: 63 and 64 years for patients with SCC and patients with IPSCC, respectively; with female patients representing 36% and 34%, respectively (p > 0.99).Smokers represented 64% of the patients with SCC and 55% of patients with IPSCC (p = 0.3); excessive alcohol intake was noted in 16% of the patients with SCC and 21% of the patients with IPSCC (p = 0.56).The maxillary sinus was most commonly involved, followed by the nasal cavity (51% versus 35% SCC, 45% versus 38% IPSCC). Frontal ethmoid and sphenoid sinuses contained primary tumors only in patients with SCC. Upfront treatment was surgery in 84% of patients with SCC and 97% of patients with IPSCC (p = 0.18); 68 and 55% received radiation, respectively, and 25 and 21% received chemotherapy, respectively.Overall survival averaged 5.5 and 3.4 years for patients with SCC and patients with IPSCC, respectively (p = 0.12); disease-free survival was 4.8 and 2.9 years, respectively (p = 0.18). Nodal metastasis was more likely in patients with SCC (18 versus 0%; p = 0.02). When divided into high- and low-stage disease: more common nodal metastases were demonstrated in high-stage SCC than in low-stage disease (p = 0.03). Overall survival was decreased between high- and low-grade disease but not when subdivided between SCC and IPSCC.
Although SCC with and without IP association are considered different diseases, their demographics and outcomes seem similar. Nodal metastasis was noted to be higher in the SCC cohort, which may indicate different tumor biology. Further study is warranted.
鼻窦鳞状细胞癌（SCC）占所有恶性肿瘤的比例不到1%，但占鼻窦癌的70%。高达10%的SCC与内翻性乳头状瘤相关（IPSCC）。文献中缺乏比较SCC和IPSCC患者、治疗方法及预后的研究。
对1995年至2015年在克利夫兰诊所和印第安纳大学就诊的SCC患者和IPSCC患者进行回顾性研究。分析患者的人口统计学资料、肿瘤特征、治疗方法及预后。
该研究共纳入117例SCC患者，其中29例为IPSCC。诊断时的平均年龄相似：SCC患者和IPSCC患者分别为63岁和64岁；女性患者分别占36%和34%（p>0.99）。吸烟者在SCC患者中占64%，在IPSCC患者中占55%（p = 0.3）；16%的SCC患者和21%的IPSCC患者有过量饮酒史（p = 0.56）。上颌窦最常受累，其次是鼻腔（SCC分别为51%和35%，IPSCC分别为45%和38%）。额筛窦和蝶窦仅在SCC患者中出现原发性肿瘤。84%的SCC患者和97%的IPSCC患者初始治疗为手术（p = 0.18）；分别有68%和55%的患者接受放疗，25%和21%的患者接受化疗。SCC患者和IPSCC患者的总生存期平均分别为5.5年和3.4年（p = 0.12）；无病生存期分别为4.8年和2.9年（p = 0.18）。SCC患者发生淋巴结转移的可能性更高（18%对0%；p = 0.02）。当分为高分期和低分期疾病时：高分期SCC患者比低分期疾病患者出现更常见的淋巴结转移（p = 0.03）。高分级和低分级疾病之间总生存期降低，但在SCC和IPSCC细分时未出现这种情况。
尽管伴有和不伴有IP关联的SCC被认为是不同的疾病，但其人口统计学特征和预后似乎相似。SCC队列中淋巴结转移率较高，这可能表明肿瘤生物学特性不同。有必要进一步研究。
