Sun Huajun, Shi Yanfen, Liang Dongni, Liu Juan, Xu Gang, Yang Xudan
Department of Pathology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Department of Pathology, University of Electronic Science and Technology of China, Chengdu, China.
Department of Pathology, China-Japan Friendship Hospital, Beijing, China.
Indian J Cancer. 2024 Oct 1;61(4):759-765. doi: 10.4103/ijc.IJC_173_21. Epub 2025 Feb 17.
Esophageal mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) are now known as a neuroendocrine component mixed with a nonneuroendocrine component in a single neoplasm, one of which is in the form of mixed small cell-squamous cell carcinoma. Collision tumors have been excluded from the category of MiNENs, but difference between mixed and collision small cell-squamous cell carcinoma has never been reported.
We collected six cases and reviewed 11 cases of mixed or collision small cell-squamous cell carcinoma (MCSSC); the data from 17 cases of MCSSC were analyzed to observe their clinicopathological features.
Most of the MCSSC patients were middle-aged and elderly, with more men than women, and most of the tumors occurred in the middle and lower esophagus. We found that in mixed cancers, the metastases were a mixture of squamous cell carcinoma and small cell carcinoma, whereas metastatic foci in collisional tumors showed simple cancer components; this phenomenon has never been reported before. Mixed cancers account for a higher proportion of small cell carcinomas, a higher pathological stage, and a worse prognosis than collisional cancers. PD-L1 (22C3) was negative in both squamous cell carcinoma and small cell carcinoma regions (<1%).
Mixed and collisional small cell-squamous cell carcinomas are essentially distinct tumors. In the clinical diagnostic of MCSSC, the tumor should be clearly identified as mixed or collisional carcinoma to guide the clinical treatment and prognosis more accurately.
食管混合性神经内分泌-非神经内分泌肿瘤（MiNENs）现被定义为单一肿瘤中神经内分泌成分与非神经内分泌成分混合，其中一种形式为混合性小细胞-鳞状细胞癌。碰撞瘤已被排除在MiNENs范畴之外，但混合性与碰撞性小细胞-鳞状细胞癌之间的差异此前从未有过报道。
我们收集了6例病例，并回顾了11例混合性或碰撞性小细胞-鳞状细胞癌（MCSSC）；对17例MCSSC的数据进行分析，以观察其临床病理特征。
大多数MCSSC患者为中老年，男性多于女性，且大多数肿瘤发生于食管中下段。我们发现，在混合性癌中，转移灶为鳞状细胞癌和小细胞癌的混合，而碰撞瘤中的转移灶显示为单一癌成分；这一现象此前从未有过报道。与碰撞性癌相比，混合性癌中小细胞癌所占比例更高，病理分期更高，预后更差。在鳞状细胞癌和小细胞癌区域，程序性死亡受体1配体（PD-L1，22C3）均为阴性（<1%）。
混合性与碰撞性小细胞-鳞状细胞癌本质上是不同的肿瘤。在MCSSC的临床诊断中，应明确肿瘤是混合性还是碰撞性癌，以便更准确地指导临床治疗和判断预后。
