口底基底样鳞状细胞癌
Basaloid squamous cell carcinoma of floor of mouth.
作者信息
Coppola D, Catalano E, Tang C K, Elfenbein I B, Harwick R, Mohr R
机构信息
Department of Pathology, Temple University Hospital and School of Medicine, Philadelphia, Pennsylvania.
出版信息
Cancer. 1993 Oct 15;72(8):2299-305. doi: 10.1002/1097-0142(19931015)72:8<2299::aid-cncr2820720803>3.0.co;2-2.
BACKGROUND
Only five cases of basaloid squamous cell carcinoma (BSCC), a rare tumor of head and neck, have been reported to involve the floor of mouth.
METHODS
Clinicopathologic and immunohistochemical features of eight BSCC of floor of mouth were studied to evaluate the significance of the basaloid features.
RESULTS
Five patients were male and three were female. Their mean age was 52 years (range, 39-59). At presentation, one patient was diagnosed with Stage II disease, four were diagnosed with Stage III disease, and three were diagnosed with Stage IV disease. Aside from typical squamous differentiation, each patient had a component of basaloid cells arranged in irregular nests, cords, or pseudoglandular spaces with a brisk mitotic rate, myxoid stroma, and marked tendency for perineural invasion. A panel of immunostains yielded the following results: keratin, +8/8; carcinoembryonic antigen, +3/8; and S-100, chromogranin, and neuron-specific enolase were negative. Mucin stains were negative in all cases. Ultrastructural characterization of three BSCC revealed squamous differentiation of the basaloid cells and a peculiar basal membrane-like material in between them. No neurosecretory granules were present. Seven patients underwent surgery; six of them were also treated with postoperative radiation therapy. In two cases, chemotherapy was added at recurrence. One nonresectable patient received radiation and chemotherapy. At the last follow-up, five patients were dead of disease within 13 months from the diagnosis. One patient died of an unknown cause. Two patients were still alive at the time of this report, 4 and 2 months after treatment. Seven patients had recurrent disease. The authors compared these data with a control group of patients with conventional squamous cell carcinoma (SCC).
CONCLUSIONS
The authors' results indicate that BSCC of floor of mouth is an aggressive variant of SCC and is prognostically worse than the conventional SCC, regardless of the grade of the latter.
背景
据报道，仅5例基底样鳞状细胞癌（一种罕见的头颈部肿瘤）累及口腔底部。
方法
对8例口腔底部基底样鳞状细胞癌的临床病理及免疫组化特征进行研究，以评估基底样特征的意义。
结果
5例为男性，3例为女性。平均年龄52岁（范围39 - 59岁）。就诊时，1例患者诊断为Ⅱ期疾病，4例诊断为Ⅲ期疾病，3例诊断为Ⅳ期疾病。除典型的鳞状分化外，每位患者均有基底样细胞成分，呈不规则巢状、条索状或假腺腔样排列，有活跃的有丝分裂率、黏液样间质，且有明显的神经周围浸润倾向。一组免疫染色结果如下：角蛋白，8/8阳性；癌胚抗原，3/8阳性；S - 100、嗜铬粒蛋白和神经元特异性烯醇化酶均为阴性。所有病例黏液染色均为阴性。3例基底样鳞状细胞癌的超微结构特征显示基底样细胞有鳞状分化，且细胞间有特殊的基底膜样物质。未见神经分泌颗粒。7例患者接受了手术治疗；其中6例还接受了术后放疗。2例患者复发时加用了化疗。1例不可切除的患者接受了放疗和化疗。在最后一次随访时，5例患者在诊断后13个月内死于疾病。1例患者死于不明原因。2例患者在本报告时仍然存活，治疗后分别为4个月和2个月。7例患者有疾病复发。作者将这些数据与传统鳞状细胞癌（SCC）患者的对照组进行了比较。
结论
作者的结果表明，口腔底部基底样鳞状细胞癌是鳞状细胞癌的一种侵袭性变体，无论后者的分级如何，其预后均比传统鳞状细胞癌差。
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