Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
Department of Molecular Pathology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland.
Head Neck Pathol. 2022 Sep;16(3):670-678. doi: 10.1007/s12105-022-01410-3. Epub 2022 Jan 11.
Since sinonasal intestinal-type adenocarcinomas (ITAC) show resemblance to colorectal adenocarcinomas, we aimed to investigate novel prognostic factors of outcome, with particular focus on the role of tumor budding (TB). Retrospective clinico-pathological single-institution study on consecutive ITAC patients between 1996 and 2020. Histopathological parameters including conventional subtypes and TB features (low, intermediate, high) were evaluated with the aid of pancytokeratin (AE1/AE3) immunohistochemical staining. Parameters were correlated to clinical data and outcome. A total of 31 ITAC patients were included. Overall, 19/31 patients (61.3%) presented with stage III/IV disease. Presence of lymph node or distant metastases was rare (1/31 patient, 3.2%). Treatment protocols consisted of tumor resection in 30/31 patients (96.8%) and primary radiochemotherapy in 1/31 patient (3.2%). Adjuvant radiation therapy was conducted in 20/30 surgically treated patients (66.7%). The 3- and 5-year overall survival (OS) was 83.9% and 78.3% and the 3- and 5-years disease-specific survival (DSS) 83.7% % and 78.5%, respectively. The presence of intermediate/high TB (defined as ≥ 5 buds) was associated with both, worse DSS (log rank p = 0.03) and OS (log rank p = 0.006). No patient with low TB revealed progressive disease or died of the disease. No association between TB and tumor stage or conventional tumor subtype was found. Tumor budding seems to be an independent prognostic factor of worse outcome in ITAC.
由于鼻窦肠型腺癌（ITAC）与结直肠腺癌具有相似性，我们旨在研究新的预后因素，特别关注肿瘤芽（TB）的作用。对 1996 年至 2020 年间连续的 ITAC 患者进行回顾性临床病理单机构研究。借助细胞角蛋白（AE1/AE3）免疫组织化学染色评估组织病理学参数，包括常规亚型和 TB 特征（低、中、高）。参数与临床数据和结果相关联。共纳入 31 例 ITAC 患者。总体而言，19/31 例（61.3%）患者表现为 III/IV 期疾病。淋巴结或远处转移的发生率较低（1/31 例，3.2%）。31 例患者中，30 例（96.8%）接受肿瘤切除术，1 例（3.2%）接受原发放化疗。20/30 例手术治疗患者接受辅助放疗（66.7%）。3 年和 5 年总生存率（OS）分别为 83.9%和 78.3%，3 年和 5 年疾病特异性生存率（DSS）分别为 83.7%和 78.5%。中/高 TB（定义为≥5 个芽）的存在与 DSS（对数秩检验 p=0.03）和 OS（对数秩检验 p=0.006）均较差相关。低 TB 组无一例患者出现疾病进展或死于该病。TB 与肿瘤分期或常规肿瘤亚型之间无关联。肿瘤芽似乎是 ITAC 预后较差的独立预后因素。
