de Araújo Amanda Bueno, Serrano Thiago Luís Infanger, Pedroso Maria Cláudia Mota, Mariano Fernanda Viviane, Altemani Albina, Gripp Flavio Mignone, Crespo Agrício Nubiato, Chone Carlos Takahiro
Department of Otorhinolaryngology, Head Neck, University of Campinas, UNICAMP, PO BOX 6111, Campinas, São Paulo, Postal Code: 13081-970, Brazil.
Department of Surgical Pathology, University of Campinas, UNICAMP, Campinas, São Paulo, Brazil.
Pathol Oncol Res. 2020 Apr;26(2):1097-1104. doi: 10.1007/s12253-019-00654-9. Epub 2019 May 9.
Spindle cell carcinoma (SpCC) is a rare tumor, which occurs in upper respiratory tract, mainly in larynx. This study aimed to review the clinical and pathological characteristics for diagnosis and prognosis. Retrospective cohort study. All patients with SpCC in upper respiratory tract treated for curative intent was included. All patients were reviewed in search of epithelial component and immunohistochemistry when not found. It was evaluated rate of recurrence and disease-free survival with univariate and multivariate analysis with Kaplan Meier and Cox Regression model adjusted to propensity score indexes (PSI) according to age, gender, site of tumor, stage, surgical treatment, status of margins of surgical resection, lymphatic invasion. There were 16 cases of SpCC.31% were diagnosed with light microscopy and others with immunohistochemistry for epithelial marker. Disease-free survival was higher in early stage disease in univariate and multivariate analysis, as the main prognostic factor. Surgical treatment increases in 2.54 the rate of survival. The SpCC is a rare tumor considered a highly malignant variant of squamous cell carcinoma. It has male predominance and tobacco use as risk factors. Its treatment should follow the same recommendations for squamous cell carcinoma, with surgery as the maintain treatment. Immunohistochemistry is an adjuvant important tool for diagnosis of SpCC.
梭形细胞癌(SpCC)是一种罕见肿瘤,发生于上呼吸道,主要在喉部。本研究旨在回顾其临床和病理特征以用于诊断和预后评估。回顾性队列研究。纳入所有接受根治性治疗的上呼吸道SpCC患者。对所有患者进行复查,寻找上皮成分,若未发现则进行免疫组化检查。采用Kaplan Meier法和Cox回归模型,根据年龄、性别、肿瘤部位、分期、手术治疗、手术切缘状态、淋巴浸润情况对倾向评分指数(PSI)进行单因素和多因素分析,评估复发率和无病生存率。共有16例SpCC患者。31%通过光学显微镜诊断,其他通过上皮标志物免疫组化诊断。在单因素和多因素分析中,早期疾病的无病生存率更高,是主要的预后因素。手术治疗使生存率提高2.54倍。SpCC是一种罕见肿瘤,被认为是鳞状细胞癌的高度恶性变体。男性居多,吸烟是危险因素。其治疗应遵循与鳞状细胞癌相同的建议,以手术作为主要治疗方法。免疫组化是诊断SpCC的重要辅助工具。