Miyazaki Masaru, Aoki Mikiko, Okado Yasuko, Koga Kaori, Hamasaki Makoto, Kiyomi Fumiaki, Sakata Toshifumi, Nakagawa Takashi, Nabeshima Kazuki
Department of Pathology, Fukuoka University Hospital and School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Department of Otorhinolaryngology, Fukuoka University Hospital and School of Medicine, Fukuoka, Japan.
Head Neck Pathol. 2019 Jun;13(2):198-207. doi: 10.1007/s12105-018-0939-x. Epub 2018 May 30.
Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is rare and offers a poor prognosis; more accurate prognostic biomarkers are required. Our laboratory recently demonstrated that tumor budding, characterized by tumor cell clusters (< 5 cells), and laminin 5-γ2 staining of SCC of the EAC are associated with shorter survival. However, clusters composed of ≥ 5 tumor cells are also found in the stroma. Previous reports of colorectal cancer suggest that poorly differentiated clusters (PDCs) are a negative prognostic indicator. Here, we report on the association between PDCs and prognosis in SCC of the EAC. PDCs and tumor budding were histopathologically and immunohistochemically (cytokeratin AE1/AE3) analyzed in 31 cases of pre-treatment biopsy SCC of the EAC. Clusters in the stroma composed of < or ≥ 5 cancer cells were defined as tumor budding or PDCs, respectively. Entire tumors were initially scanned to identify greatest PDC density. Tumors with low or high PDC density were classified as low- and high-grade, respectively. Patients with high-grade PDCs had a significantly poorer outcome than those with low-grade. Even in cases of low-grade tumor budding, those with high-grade PDCs had a poor prognosis. Multivariate analysis results indicated that high-grade PDCs were associated with poor prognosis. PDC grade can provide a more accurate prognosis than tumor budding in SCC of the EAC.
外耳道鳞状细胞癌（SCC）较为罕见，预后较差，因此需要更准确的预后生物标志物。我们实验室最近发现，以肿瘤细胞簇（<5个细胞）为特征的肿瘤芽生以及外耳道SCC的层粘连蛋白5-γ2染色与较短生存期相关。然而，在基质中也发现了由≥5个肿瘤细胞组成的细胞簇。先前关于结直肠癌的报道表明，低分化细胞簇（PDCs）是一种不良预后指标。在此，我们报告外耳道SCC中PDCs与预后之间的关联。对31例外耳道SCC治疗前活检病例的PDCs和肿瘤芽生进行了组织病理学和免疫组织化学（细胞角蛋白AE1/AE3）分析。基质中由<或≥5个癌细胞组成的细胞簇分别定义为肿瘤芽生或PDCs。对整个肿瘤进行初步扫描以确定最大的PDC密度。PDC密度低或高的肿瘤分别分为低级别和高级别。高级别PDCs患者的预后明显比低级别患者差。即使在低级别肿瘤芽生的病例中，高级别PDCs患者的预后也较差。多变量分析结果表明，高级别PDCs与不良预后相关。在外耳道SCC中，PDC分级比肿瘤芽生能提供更准确的预后。
