Gallo O, Graziani P, Fini-Storchi O
O.R.L. Clinic, University of Florence, Firenze-Italia.
Ear Nose Throat J. 1993 Sep;72(9):588-90, 593-5.
Among twenty-six "undifferentiated" tumors of the nasal cavity and paranasal sinuses treated from 1970 to 1990 at the Institute of Otolaryngology of Florence University, 13 were ultimately diagnosed as true undifferentiated sinusonasal carcinoma (SNUC) by conventional light microscopy and use of monoclonal antibodies to epithelial membrane antigen and cytokeratins. SNUC patients, who ranged in age from 20 to 82 years, often had multiple sinonasal symptoms due to very large tumors (nine of 13 tumors were staged as T3-T4) with short average delay of 4 months between onset of symptoms and diagnosis. Both data suggest the high growth capacity and aggressiveness of such a tumor. In our series, follow-up evidenced an overall crude 5-year survival rate of 15.5%. Worse prognostic factors are neck metastases and orbital invasion, according to the behavior of more common carcinomas of the nose and paranasal sinuses. We also found a better prognosis for SNUC primarily arisen in the nasal cavity than in paranasal sinuses (crude 5-year survival rate of 66% vs. 10%, respectively). The histopathological and clinical analysis of our series shows that SNUC is a highly aggressive, uncommon tumor of the nose paranasal sinuses, which should be recognized in advance for a more aggressive treatment by combined multiple therapy.
1970年至1990年间，佛罗伦萨大学耳鼻喉科研究所收治了26例鼻腔和鼻窦“未分化”肿瘤患者，其中13例经传统光学显微镜检查及使用抗上皮膜抗原和细胞角蛋白的单克隆抗体，最终被确诊为真正的鼻窦未分化癌（SNUC）。SNUC患者年龄在20至82岁之间，由于肿瘤巨大（13例肿瘤中有9例分期为T3 - T4），常出现多种鼻窦症状，症状出现至诊断的平均延迟时间较短，仅4个月。这两个数据均表明此类肿瘤具有高生长能力和侵袭性。在我们的系列研究中，随访显示总体5年粗生存率为15.5%。根据鼻腔和鼻窦常见癌的行为，预后较差的因素是颈部转移和眼眶侵犯。我们还发现，主要发生在鼻腔的SNUC比发生在鼻窦的预后更好（5年粗生存率分别为66%和10%）。我们系列研究的组织病理学和临床分析表明，SNUC是一种侵袭性很强的、不常见的鼻腔鼻窦肿瘤，应提前识别以便采用更积极的联合多疗法进行治疗。
