螺旋腺癌、圆柱癌和螺旋腺圆柱癌7例临床病理学分析  

Spiradenocarcinoma,cylindrocarcinoma and spiradenocylindrocarcinoma:a clinicopathological study of seven cases

作　　者：吕矫洁 蔡旭 吕娜 张岩 蒋雪兵 任敏 孔蕴毅 Lyu Jiaojie;Cai Xu;Lyu Na;Zhang Yan;Jiang Xuebing;Ren Min;Kong Yunyi(Department of Pathology,Shanghai Cancer Center,Fudan University and Department of Oncology,Shanghai medical College,Fudan University,Shanghai 200032,China;Department of Pathology,Minhang Hospital,Fudan University,Shanghai 201100,China)

机构地区：[1]复旦大学附属肿瘤医院病理科、复旦大学上海医学院肿瘤学系、复旦大学病理研究所,上海200032 [2]复旦大学附属闵行医院病理科,上海201100

出　　处：《中华病理学杂志》2024年第12期1224-1230,共7页Chinese Journal of Pathology

基　　金：上海市临床重点专科建设项目-病理科(shslczdzk01301)。

摘　　要：目的探讨螺旋腺癌、圆柱癌和螺旋腺圆柱癌的临床病理学特征,探究预后与组织学类型的相关性。方法收集2015—2021年复旦大学附属肿瘤医院诊断的7例螺旋腺癌、圆柱癌和螺旋腺圆柱癌,回顾性分析其临床病理学特征及随访资料。常规行HE和免疫组织化学进行形态学观察。结果患者男性4例,女性3例,年龄46~75岁(平均年龄61岁)。发生部位头颈部4例,四肢2例,躯干1例。组织学上,7例均有良性肿瘤残留。恶性区域1例呈低级别涎腺型基底细胞样腺癌(salivary gland-type basal cell adenocarcinoma-like pattern,low-grade;BCAC-LG)类型,1例呈高级别涎腺型基底细胞样腺癌(salivary gland-type basal cell adenocarcinoma-like pattern,high-grade;BCAC-HG)类型。其余5例均为浸润性腺癌,非特指型(invasive adenocarcinoma,not otherwise specified;IAC-NOS)。其中1例IAC-NOS中出现黏液腺癌成分。免疫组织化学显示,BCAC-LG和BCAC-HG以表达p63及p40等基底样细胞标志物为主,而IAC-NOS以细胞角蛋白(CK)7阳性腺上皮标志物为主。6例患者获得随访,随访时间1~9年(平均4.5年)。4例恶变成分为腺癌且有随访的患者,3例发生复发,其中2例发生区域淋巴结转移,1例患者死亡。结论螺旋腺瘤、圆柱瘤和螺旋腺圆柱瘤恶变形态可表现为BCAC-LG、BCAC-HG及IAC-NOS。本组研究报道了IAC-NOS中出现黏液腺癌的成分,并提示恶变成分是IAC-NOS的患者预后相对较差。Objective To investigate the clinicopathological characteristics of spiradenocarcinoma,cylindrocarcinoma,and spiradenocylindrocarcinoma,and to understand the correlations between their morphological patterns and clinical behaviors.MethodsSeven cases of spiradenocarcinoma,cylindrocarcinoma,and spiradenocylindrocarcinoma diagnosed at Fudan University Shanghai Cancer Center,Shanghai,China from 2015 to 2021 were collected.The clinicopathological characteristics and follow-up data were retrospectively analyzed.Histopathologic evaluation and immunohistochemical studies were carried out.ResultsThere were four men and three women in the cohort,with ages ranging from 46 to 75 years(mean,61 years).The tumors were located on the head and neck(four cases),extremities(two cases),and trunk(one case).Histologically,the residuum of a benign neoplasm was present in all cases.One case presented salivary gland-type basal cell adenocarcinoma-like pattern,low-grade(BCAC-LG).Another case showed salivary gland-type basal cell adenocarcinoma-like pattern,high-grade(BCAC-HG).The remaining five cases were invasive adenocarcinoma,not otherwise specified(IAC-NOS).One of IAC-NOS contained a mucinous adenocarcinoma component.Immunohistochemically,BCAC-LG and BCAC-HG predominantly expressed basal cell markers such as p63 and p40,whereas IAC-NOS primarily exhibited positivity for CK7,a glandular epithelial marker.Follow-up was available for six patients,ranging from 1 to 9 years(mean,4.5 years).Among the four patients of IAC-NOS with follow-up,three showed recurrences,two had regional lymph node metastases,and one died.ConclusionsThe malignant components of spiradenocarcinomas,cylindrocarcinomas,and spiradenocylindrocarcinomas in this cohort contain BCAC-LG,BCAC-HG and IAC-NOS.This study also shows the presence of mucinous adenocarcinoma components in IAC-NOS.The tumors with IAC-NOS have a relatively poorer prognosis than those without.

关 键 词：皮肤肿瘤 免疫组织化学 预后 

分 类 号：R739.5[医药卫生—肿瘤]