腺鳞癌：一种侵袭性组织学亚型的结肠癌，预后不良。
Adenosquamous carcinoma: An aggressive histologic sub-type of colon cancer with poor prognosis.
机构信息
Cedars-Sinai Medical Center, Los Angeles, CA, USA; Surgery Group Los Angeles, Los Angeles, CA, USA.
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
出版信息
Am J Surg. 2021 Mar;221(3):649-653. doi: 10.1016/j.amjsurg.2020.07.038. Epub 2020 Aug 22.
BACKGROUND
Studies have reported worse overall survival (OS) for adenosquamous carcinoma (ASC) compared to adenocarcinoma (AC) of the colon, but none have analyzed a national dataset for over 30 years.
METHODS
The National Cancer Database was queried from 2004 to 2016 for patients with ASC and AC of the colon. Kaplan-Meier survival analysis was performed to assess OS. Descriptive variables were evaluated using independent T-test and Chi-square analyses.
RESULTS
332 ASC patients were compared to 496,950 AC patients. AC patients were older than ASC patients (68.6 vs. 64.4 years); p < 0.001. Most ASC cancers presented with stage IV (41.3%) and poorly-differentiated disease (57.5%) compared to AC (22.4% and 17.7%). OS of the ASC cohort was 13.9 months. Median OS for stage IV AC versus stage IV ASC was significantly better (14.1 vs. 8.0 months); p < 0.0001.
CONCLUSION
This is the largest national database study to compare ASC with AC. Our findings confirm that unlike AC, ASC most frequently presents late stage, as poorly-differentiated lesions, and have worse OS.
背景
已有研究报告称，结肠的腺鳞癌（ASC）总体生存率（OS）较腺癌（AC）差，但尚无研究在 30 多年来分析过全国性数据集。
方法
从 2004 年至 2016 年，国家癌症数据库中检索到 ASC 和结肠 AC 的患者。采用 Kaplan-Meier 生存分析评估 OS。使用独立 T 检验和卡方分析评估描述性变量。
结果
332 例 ASC 患者与 496950 例 AC 患者进行比较。AC 患者比 ASC 患者年龄大（68.6 岁 vs. 64.4 岁）；p<0.001。与 AC 相比，大多数 ASC 癌症表现为 IV 期（41.3%）和低分化疾病（57.5%）。ASC 队列的 OS 为 13.9 个月。IV 期 AC 与 IV 期 ASC 的中位 OS 明显更长（14.1 个月 vs. 8.0 个月）；p<0.0001。
结论
这是比较 ASC 与 AC 的最大的全国性数据库研究。我们的研究结果证实，与 AC 不同，ASC 最常表现为晚期、低分化病变，且 OS 更差。
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