Wang J L, Liu L, Jin R J, Sang J Z, Cao H, Sun J, Zhang Z F, Chen L, Guo X C
Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Department of Medicine, Henan Medical College, Zhengzhou 451191, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr 7;56(4):381-386. doi: 10.3760/cma.j.cn115330-20201003-00782.
To investigate the clinicopathological characteristics, treatment and prognosis of head and neck carcinosarcoma. The clinical data of 14 patients with head and neck carcinosarcoma treated in the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2020 were retrospectively analyzed, including 11 males and 3 females, with age range from 30 to 72 years old. Clinicopathological characteristics, treatments and follow-up results of patients were evaluated. Kaplan-Meier method was used to estimate the cumulative survival rate. Histopathological examination showed the co-existence of malignant epithelial and mesenchymal components in all cases. Immunohistochemical staining of 13 cases showed cytokeratin and epithelial membrane antigens were positively expressed in the epithelial areas, whereas vimentin was positive in the malignant mesenchymal tissue area. Among 14 cases, 5 cases were treated with surgery, 3 cases with surgery and radiotherapy, and 6 cases with surgery, radiotherapy and chemotherapy. The follow-up time was 2-81 months, with a median follow-up time of 22.5 months. Except for one patient who was lost to follow-up in 21 months after treatment, among the remaining 13 patients, 4 patients had recurrence, 8 patients died, and 5 patients had a tumor-free survival. The Kaplan-Meier analysis showed that the 1, 3, and 5-year cumulative survival rates of 14 patients with head and neck carcinosarcoma were 64.3%, 57.1%, and 42.9%, respectively. Carcinosarcoma of the head and neck is rare in clinic, histopathological and immunohistochemical examinations are important basis for diagnosis, and surgery is a preferred treatment. Carcinosarcoma of the head and neck has a poor prognosis, and patients should be followed up for a long time.
探讨头颈部癌肉瘤的临床病理特征、治疗方法及预后。回顾性分析2010年1月至2020年5月在郑州大学第一附属医院接受治疗的14例头颈部癌肉瘤患者的临床资料，其中男性11例，女性3例，年龄30～72岁。评估患者的临床病理特征、治疗方法及随访结果。采用Kaplan-Meier法估计累积生存率。组织病理学检查显示所有病例均存在恶性上皮和间叶成分。13例免疫组织化学染色显示，细胞角蛋白和上皮膜抗原在上皮区域呈阳性表达，而波形蛋白在恶性间叶组织区域呈阳性。14例患者中，5例行手术治疗，3例行手术加放疗，6例行手术、放疗加化疗。随访时间为2～81个月，中位随访时间为22.5个月。除1例患者治疗后21个月失访外，其余13例患者中，4例复发，8例死亡，5例无瘤生存。Kaplan-Meier分析显示，14例头颈部癌肉瘤患者的1年、3年和5年累积生存率分别为64.3%、57.1%和42.9%。头颈部癌肉瘤临床罕见，组织病理学和免疫组织化学检查是诊断的重要依据，手术是首选治疗方法。头颈部癌肉瘤预后较差，应长期随访患者。
