School of Medicine, Griffith University, Gold Coast, Australia.
Endocr Relat Cancer. 2020 Jun;27(6):R177-R192. doi: 10.1530/ERC-20-0045.
The aim is to review the features of 117 primary squamous cell carcinomas of thyroid which meet the histological criteria of the World Health Organization classification of endocrine tumours. The carcinomas occur in 83 women and 34 men (female to male ratio is 2.4 to 1) and with median age at presentation of 64. Half of these squamous cell carcinomas of thyroid were moderately differentiated. PAX-8 protein is a sensitive marker for confirming the thyroid origin of the carcinoma. The carcinoma is also positive for p63, p40, cytokeratins 5/6, 7,19 and negative for cytokeratins 20 and 10/13. P53 overexpression is common. The most important differential diagnosis is direct infiltration or metastatic involvement by squamous cell carcinoma from other organs. Limited mutation analysis revealed BRAF mutation in some squamous cell carcinomas of the thyroid. The genetic profile appears to be different from anaplastic thyroid carcinomas. Primary squamous cell carcinoma of thyroid had lymph node involvement in 59% and distant metastases in 26%. The median survival of the patients was 8 months. Curative surgery offers the best survival for the patients with the carcinoma. To conclude, primary squamous cell carcinoma of the thyroid gland has distinctive clinical, pathological and molecular profiles. It is important to recognize this unique variant of thyroid carcinoma for possible curative surgical resection and to do more genomic works on the entity to uncover the molecular pathogenesis.
目的是回顾符合世界卫生组织内分泌肿瘤分类组织学标准的 117 例原发性甲状腺鳞状细胞癌的特征。这些癌发生于 83 名女性和 34 名男性（女性与男性的比例为 2.4:1），发病时的中位年龄为 64 岁。这些甲状腺鳞状细胞癌中有一半为中度分化。PAX-8 蛋白是确认癌来源于甲状腺的敏感标志物。该癌还对 p63、p40、细胞角蛋白 5/6、7、19 呈阳性，对细胞角蛋白 20 和 10/13 呈阴性。P53 过表达很常见。最重要的鉴别诊断是来自其他器官的鳞状细胞癌的直接浸润或转移性累及。有限的突变分析显示，一些甲状腺鳞状细胞癌存在 BRAF 突变。该基因谱似乎与间变性甲状腺癌不同。原发性甲状腺鳞状细胞癌的淋巴结受累率为 59%，远处转移率为 26%。患者的中位生存时间为 8 个月。根治性手术为患者提供了最佳的生存机会。总之，甲状腺原发性鳞状细胞癌具有独特的临床、病理和分子特征。认识到这种独特的甲状腺癌变体对于可能的根治性手术切除很重要，并对该实体进行更多的基因组研究以揭示其分子发病机制。
