胰腺腺鳞癌是一组预后最差的异质性肿瘤:对562例接受根治性切除的胰腺癌中确诊的25例进行临床病理分析
Adenosquamous Carcinoma of the Pancreas Comprise a Heterogeneous Group of Tumors With the Worst Outcome: A Clinicopathological Analysis of 25 Cases Identified in 562 Pancreatic Carcinomas Resected With Curative Intent.
作者信息
Boecker Joerg, Feyerabend Bernd, Tiemann Katharina, Buchwalow Igor, Wagner Kim C, Oldhafer Karl J, Andruszkow Julia, Daniels Thies, Boessow Dorthe, Boecker Werner, Neumann Ulf Peter
机构信息
From the Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen.
Department of Pathology, Asklepios Clinic Barmbek.
出版信息
Pancreas. 2020 May/Jun;49(5):683-691. doi: 10.1097/MPA.0000000000001548.
OBJECTIVES
Information of the clinicopathological characteristics and outcome data of patients with adenosquamous carcinoma of the pancreas (ASCAP) remains limited. This study's aim is to describe the clinical, pathological, and molecular characteristics of 25 resected ASCAPs.
METHODS
Of all 25 cases, patient characteristics, follow-up data, and pathological/immunohistological features were reviewed and analyzed.
RESULTS
In this 3-institutional retrospective analysis of 562 pancreatic cancer patients, we identified 25 cases with histologically confirmed ASCAP (4.4%). Follow-up was available in 21 ASCAP and 50 pancreatic ductal adenocarcinoma control patients with a median overall survival of 8.2 and 21 months, respectively. Age, tumor size, localization in the tail, lymph node status, and resection margin seem to be the most significant factors of survival in our ASCAP cohort. In contrast to pancreatic ductal adenocarcinoma, positive expression of p63, keratins K5/14, and the epidermal growth factor receptor are a robust marker profile of these tumors.
CONCLUSIONS
Adenosquamous carcinoma of the pancreas comprises a group of neoplasms in which stage and adverse morphological features contribute to its bad prognosis. Further work must be pursued to improve detection and treatment options to reduce mortality. Specifically, differences in biology might become a target for the development of possible therapies.
目的
胰腺腺鳞癌(ASCAP)患者的临床病理特征及预后数据仍然有限。本研究旨在描述25例接受手术切除的ASCAP的临床、病理及分子特征。
方法
对全部25例病例的患者特征、随访数据以及病理/免疫组织学特征进行回顾和分析。
结果
在对562例胰腺癌患者进行的三机构回顾性分析中,我们确定了25例经组织学确诊的ASCAP(4.4%)。21例ASCAP患者和50例胰腺导管腺癌对照患者有随访数据,其总生存期的中位数分别为8.2个月和21个月。年龄、肿瘤大小、位于胰尾、淋巴结状态及手术切缘似乎是我们ASCAP队列中最重要的生存因素。与胰腺导管腺癌不同,p63、角蛋白K5/14及表皮生长因子受体的阳性表达是这些肿瘤的可靠标志物特征。
结论
胰腺腺鳞癌是一组肿瘤,其中分期及不良形态学特征导致其预后不良。必须进一步开展工作以改善检测及治疗方案,降低死亡率。具体而言,生物学差异可能成为开发可能疗法的靶点。