包含基底层型鳞状细胞癌成分的食管病变的临床病理特征及预后

Clinicopathological features and outcomes of esophageal lesions containing a basal layer type squamous cell carcinoma component.

作者信息

Zhuang Xiaoduan, Chen Zhenyu, Wang Jianqi, Chen Junsheng, Wu Xiaosheng, Wang Yadong, Chen Chudi, Deng Guoming, Qian Kai, Bai Yang

机构信息

Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China.

Department of Otolaryngology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510515, People's Republic of China.

出版信息

Cancer Manag Res. 2019 Sep 18;11:8507-8516. doi: 10.2147/CMAR.S212380. eCollection 2019.

DOI:10.2147/CMAR.S212380

PMID:31572005

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6756149/

Abstract

PURPOSE

Basal layer type squamous cell carcinoma (BLSCC) is a unique type of squamous cell carcinoma (SCC), characterized by high-grade dysplastic cells occupying the lower half of the epithelium. So far, such special lesions do not seem to attract much attention. The aim of this study was to investigate the clinicopathological features and prognosis of esophageal squamous carcinoma lesions with a BLSCC component.

MATERIALS AND METHODS

Between January 2011 and January 2018, 96 patients with esophageal squamous cell carcinoma underwent endoscopic submucosal resection in our hospital were retrospectively analyzed. Patients were divided into BLSCC or typical SCC groups according to the presence or absence of a BLSCC component. The endoscopic findings were compared between the two groups. Furthermore, patients were followed up until October 2018 to compare recurrence rates.

RESULTS

BLSCC components were detected in 32 (33.3%, 32/96) lesions. Among them, 13 (40.62%, 13/32) were BLSCC predominant. The intraepithelial papillary capillary loops of 7 pure BLSCC showed type B1 under narrow-band imaging. Single-factor and multivariate analyses indicated that five or more independently scattered, deep-stained spots in iodine-unstained areas were significantly predictive of the presence of BLSCC components (OR=4.837, =0.015). All patients of typical SCC group survived, but one of BLSCC group died for distant metastases during the follow-up period. The 1-year cumulative recurrence rate (CRR) of BLSCC group were 3.4%, lower than that of typical SCC group (7.1%). Although no significant difference of CRR was seen between the two groups (>0.05), the 2-year CRR of BLSCC group increased to 11.9%, being higher than that of typical SCC group (7.1%).

CONCLUSION

The presence of multiple, scattered stained spots in iodine-unstained areas was predictive of BLSCC components. Such lesion should be treated actively and subject to a more rigorous follow-up protocol due to a higher likelihood of late recurrence.

摘要

目的

基底细胞型鳞状细胞癌（BLSCC）是一种独特的鳞状细胞癌（SCC）类型，其特征是高级别发育异常细胞占据上皮的下半部分。到目前为止，这种特殊病变似乎没有引起太多关注。本研究的目的是探讨具有BLSCC成分的食管鳞状细胞癌病变的临床病理特征和预后。

材料与方法

回顾性分析2011年1月至2018年1月在我院接受内镜下黏膜下切除术的96例食管鳞状细胞癌患者。根据是否存在BLSCC成分将患者分为BLSCC组或典型SCC组。比较两组的内镜检查结果。此外，对患者进行随访至2018年10月，比较复发率。

结果

在32个（33.3%，32/96）病变中检测到BLSCC成分。其中，13个（40.62%，13/32）以BLSCC为主。7例纯BLSCC的上皮内乳头毛细血管襻在窄带成像下显示为B1型。单因素和多因素分析表明，碘不着色区域中五个或更多独立散在的深染斑点显著预测BLSCC成分的存在（OR=4.837，P=0.015）。典型SCC组的所有患者均存活，但BLSCC组中有1例在随访期间因远处转移死亡。BLSCC组的1年累积复发率（CRR）为3.4%，低于典型SCC组（7.!.%）。虽然两组之间的CRR无显著差异（P>0.05），但BLSCC组的2年CRR增至11.9%，高于典型SCC组（7.1%）。