Raslan W F, Barnes L, Krause J R, Contis L, Killeen R, Kapadia S B
Department of Pathology, Presbyterian University Hospital, Pittsburgh, PA 15213.
Am J Otolaryngol. 1994 May-Jun;15(3):204-11. doi: 10.1016/0196-0709(94)90006-x.
We describe the clinicopathologic and flow cytometric features of 10 cases of basaloid squamous cell carcinoma (BSCC) of the head and neck to determine if DNA ploidy is a useful prognostic indicator. We also provide a review of 80 cases previously reported in the English language literature.
The 10 cases were obtained from the surgical pathology files of Presbyterian University Hospital and The Eye and Ear Institute, Pittsburgh, PA (1987-1991). In all 10 cases, the microscopic slides and clinical data were reviewed. Flow cytometry was performed using the Hedley technique and formalin-fixed, paraffin-embedded tissue.
The mean age of patients with BSCC was 64 years (range, 49 to 75 years). Tumor involved the base of tongue (n = 5), hypopharynx-epiglottis (n = 3), and tonsil (n = 1). One case presented with cervical lymph node metastasis from an unknown primary site. Histologically, BSCC showed a biphasic pattern with basaloid-squamous elements, comedonecrosis, stromal hyalinization, surface dysplasia, and an in situ and/or invasive squamous cell carcinoma component. Flow cytometry revealed six diploid and four aneuploid tumors. Five of six patients with diploid and all four patients with aneuploid tumors developed early regional and/or distant metastases. Of the two patients who died of disease, one had a diploid and the other an aneuploid tumor.
Our study reaffirms the predilection of BSCC for the base of tongue, pyriform sinus, and supraglottic larynx, and its aggressive biologic behavior with a high incidence of cervical lymph node metastasis (64%), distant spread (44%), and death from disease (38% mortality at 17 months median follow-up). However, in contrast to previous reports, tumor ploidy by flow cytometry provided no additional prognostic information beyond that supplied by routine histologic evaluation.
我们描述了10例头颈部基底样鳞状细胞癌（BSCC）的临床病理及流式细胞术特征，以确定DNA倍性是否为有用的预后指标。我们还对先前英文文献报道的80例病例进行了综述。
这10例病例取自宾夕法尼亚州匹兹堡长老会大学医院及眼耳研究所的外科病理档案（1987 - 1991年）。对所有10例病例的显微镜切片和临床资料进行了复查。使用Hedley技术对福尔马林固定、石蜡包埋的组织进行流式细胞术检测。
BSCC患者的平均年龄为64岁（范围49至75岁）。肿瘤累及舌根（n = 5）、下咽 - 会厌（n = 3）和扁桃体（n = 1）。1例表现为不明原发部位的颈部淋巴结转移。组织学上，BSCC呈现双相模式，具有基底样 - 鳞状成分、粉刺样坏死、间质玻璃样变、表面发育异常以及原位和/或浸润性鳞状细胞癌成分。流式细胞术显示6例二倍体肿瘤和4例非整倍体肿瘤。6例二倍体肿瘤患者中有5例以及所有4例非整倍体肿瘤患者均发生了早期区域和/或远处转移。在2例死于该疾病的患者中，1例为二倍体肿瘤，另1例为非整倍体肿瘤。
我们的研究再次证实BSCC好发于舌根、梨状窦和声门上喉，其生物学行为具有侵袭性，颈部淋巴结转移发生率高（64%）、远处转移率高（44%）以及疾病死亡率高（中位随访17个月时死亡率为38%）。然而，与先前报道不同的是，流式细胞术检测的肿瘤倍性并未提供超出常规组织学评估的额外预后信息。
