牙龈基底细胞样鳞状细胞癌1例  

Basaloid squamous cell carcinoma in gingiva: a case report

作　　者：代璐岭 杨秀秀 赵好为 韩琪 陈宇[1] Dai Luling;Yang Xiuxiu;Zhao Haowei;Han Qi;Chen Yu(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Pathology,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院病理科,成都610041

出　　处：《华西口腔医学杂志》2020年第3期343-346,共4页West China Journal of Stomatology

基　　金：四川省科技厅面上项目(2017JY0024)。

摘　　要：基底细胞样鳞状细胞癌(BSCC)是一种侵袭性较强的鳞状细胞癌亚型,在口腔颌面部发生较少,牙龈部位尤其少见。本文报告1例78岁男性患者,因左上颌骨疼痛就诊,临床检查发现左上颌骨一牙龈肿块,术后病理见基底细胞样的细胞排列成巢或腺样结构,癌巢内可见粉刺样坏死,周围细胞呈栅栏状排列。免疫组织化学染色结果示Ki-67阳性率28%,S-100阳性,P16及CK7阴性。综合病理特征以及免疫组织化学染色结果,诊断为BSCC。术后随访12个月无复发。结合相关文献,本文对BSCC的临床病理特征、鉴别诊断、诊断、治疗及预后进行分析,认为手术仍是头颈部BSCC的主要治疗方法,但对于人乳头瘤病毒阳性的病例应考虑结合放化疗的综合治疗方式。As an aggressive subtype of squamous cell carcinoma,basaloid squamous cell carcinoma(BSCC)rarely occurs in the oral and maxillofacial region.The gingiva is an unusual site of BSCC.This study reported a 78-year-old male who presented with left maxillary pain.Clinical examination revealed a gingival mass in the left maxilla.Under microscope,the lesion showed typical comedo necrosis and peripheral palisading.Areas of glandular-like structures were also observed.Immunohistochemistry results revealed that the Ki-67 score of BSCC in this case was 28%,and S-100 was positive in some areas.However,P16 and CK7 were negative.Finally,a diagnosis of BSCC was made based on the pathological and immunohistochemical characteristics.The patient underwent subtotal maxillectomy.After 12 months later,the patient was alive with no evidence of disease.Combined with relevant literature,this article analyzed the clinicopathological features,differential diagnosis,diagnosis,treatment,and prognosis of BSCC.Although surgery remains the main treatment in the head and neck region,radiation-chemotherapy should be considered in some human papilloma virus-positive cases.

关 键 词：基底细胞样鳞状细胞癌 病理 牙龈 免疫组织化学 

分 类 号：R739.8[医药卫生—肿瘤]