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目的 探讨食管基底细胞样鳞状细胞癌 (BSCC)的临床病理特征及诊断标准。方法 收集 5例食管BSCC分别作HE、组织化学及免疫组化染色 ,其中 2例作电镜观察。结果 BSCC主要由密集的小细胞组成 ,排列成实体小叶状及筛网状 (假腺样 ) ,并见粉刺样坏死、玻璃样变性及基底膜样物质沉积 (PAS + ) ,4例BSCC均见不同分化程度的鳞状细胞癌成分 ,1例见局灶性鳞状细胞分化。免疫组化Ker(AE1/AE3 )、Ker14、LM、PCNA及p5 3均阳性 ,4例Ker19阳性 ;仅见 1例Syn阳性 ;S 10 0、CgA、NSE及SMA阴性。 2例BSCC超微结构可见鳞状细胞分化及基底膜样物质沉积。患者发病年龄大 ,首次手术多数可见区域淋巴结转移 ,1例转移至肺 ,术后 2个月死亡 ;4例随访无结果。结论 BSCC是鳞状细胞癌独特的组织学类型 ,分化低 ,预后较差。
Objective To investigate the clinicopathological features and diagnostic criteria of esophageal basal cell-like squamous cell carcinoma (BSCC). Methods Five cases of esophageal BSCC were collected for HE, histochemistry and immunohistochemical staining, and 2 cases were observed by electron microscopy. Results BSCC mainly consisted of dense small cells, arranged in solid lobular and mesh (pseudoadenomas), and showed acne necrosis, hyaline degeneration, and basement membrane-like material deposition (PAS + ). Four cases of BSCC were found. Differentiating squamous cell carcinoma components, one case showed focal squamous cell differentiation. Immunohistochemical Ker (AE1/AE3), Ker14, LM, PCNA, and p53 were positive, 4 cases were positive for Ker19, and only 1 was positive for Syn; S10, CgA, NSE, and SMA were negative. In 2 cases of BSCC ultrastructure, squamous cell differentiation and basement membrane-like material deposition were observed. The age of onset was large. Most lymph nodes metastases were seen in the first operation. One patient metastasized to the lungs and died 2 months after operation. No follow-up was found in 4 patients. Conclusions BSCC is a unique histologic type of squamous cell carcinoma with low differentiation and poor prognosis.