结肠原发性腺鳞癌和鳞癌的临床病理分析  

Clinicopathologic analysis of primary colon adenosquamous carcinoma and squamous carcinoma

作　　者：王小拍[1] 杜洪[1] 李秀博 刘寿生 WANG Xiaopai;DU Hong;LI Xiuboq;LIU Shousheng(Department of Pathology,Guangzhou First People＇s Hospital,Guangzhou 510180,China;Department of General Medicine,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China)

机构地区：[1]广州市第一人民医院病理科,广州510180 [2]中山大学肿瘤防治中心综合科,华南肿瘤学国家重点实验室,肿瘤医学协同创新中心,广州510060

出　　处：《广州医药》2018年第5期94-97,共4页Guangzhou Medical Journal

基　　金：广东省自然科学基金博士启动基金(2107A030310337)

摘　　要：目的探讨结肠原发性腺鳞癌和鳞癌的临床病理特征、诊断、发病机制及预后。方法分析2例结肠原发性腺鳞癌和鳞癌的临床特点、组织学、免疫组化及基因检测特点,并结合相关文献进行讨论。结果 2例患者均因右下腹隐痛入院,平均年龄69岁,肿瘤均位于右半结肠。腺鳞癌可见腺鳞两种成分随机混合在一起,鳞癌成分免疫组化结果示CK5/6,P63均阳性,基因检测结果 (ARMS-PCR法):腺鳞癌KRAS 2号外显子突变,BRAF未突变,鳞癌KRAS和BRAF均未突变。腺鳞癌患者术后放弃治疗1个月后死亡,鳞癌患者5个月后死于肝转移。结论结肠原发性腺鳞癌/鳞癌非常少见,其临床症状与腺癌相似,但临床过程却更具侵袭性,预后相对较差,所以在临床中需得到重视。Objective To study the clinicopathologic features, diagnosis, pathogenesis and prognosis of primary colon adenosquamous carcinoma and squamous cell carcinoma. Methods We analyzed clinical features, histological morphology, immunohistochenfical results and gene mutation. Besides, relevant literatures were also reviewed. Results The two patients with an average of 69 years were admitted to the hospital clue to abnormal pain. The tumors were all located in the right hemicolon. Adenosquamous carcinoma contained both components that mixed haphazardly, Immunohistochenfistry showed that both CK5/6 and P63 were positive in squamous cell carcinoma. KRAS exon 2 mutations and BRAF wide-type were found in adenosquamous carcinoma patient, while KRAS and BRAF wide-type were found in squamous cell carcinoma patient using ARMS-PCR method. Adenosquamous carcinoma patient abandoned treatment and died after one month and the other died of liver metastasis in five months after surgery. Conclusion Primary colon adenosquamous carcinoma and squamous cell carcinoma are veryrare. They have the similar clinical symptoms, more invasive clinical processes and worse prognosis compared with adenocarcinoma, therefore should be valued in clinic.

关 键 词：腺鳞癌 鳞癌 基因突变 临床病理特征 

分 类 号：R735.35[医药卫生—肿瘤]