Weidner N
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
Semin Diagn Pathol. 1987 May;4(2):157-68.
Sarcomatoid carcinomas are typically (but not always) biphasic tumors containing both carcinomatous and sarcomatous components. Within the upper aerodigestive tract, they arise from the mucosa and are predominantly composed of pleomorphic spindled cells associated with squamous carcinoma, the latter often presenting focally at the tumor base. Although their histogenesis is still debated, most authors favor metaplastic origin of the sarcomatous cells from carcinoma cells. Indeed, when studied with electron microscopy and/or immunohistochemistry the sarcomatous cells are frequently found to retain epithelial features; however, the sarcomatous metaplasia can be so complete that malignant cartilage, bone, and/or muscle cells are formed. In addition, metastatic deposits may contain sarcomatous and/or carcinomatous components. Sarcomatoid carcinomas are potentially aggressive tumors and should be treated accordingly. Although it is difficult to predict biologic behavior in every case, patients whose tumors are deeply invasive tend to have a poor prognosis, whereas those with superficially invasive tumors usually have an excellent prognosis.
肉瘤样癌通常（但并非总是）是双相性肿瘤，包含癌性和肉瘤性成分。在上呼吸消化道内，它们起源于黏膜，主要由与鳞状细胞癌相关的多形性梭形细胞组成，后者常局灶性出现在肿瘤底部。尽管它们的组织发生仍存在争议，但大多数作者支持肉瘤性细胞由癌细胞化生而来。实际上，当用电子显微镜和/或免疫组织化学研究时，经常发现肉瘤性细胞保留上皮特征；然而，肉瘤样化生可能非常彻底，以至于形成恶性软骨、骨和/或肌肉细胞。此外，转移灶可能包含肉瘤性和/或癌性成分。肉瘤样癌是潜在的侵袭性肿瘤，应相应地进行治疗。尽管很难在每种情况下预测生物学行为，但肿瘤浸润较深的患者预后往往较差，而肿瘤浅表浸润的患者通常预后良好。
