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目的 探讨食管基底细胞样鳞癌 (BSCC)的临床病理特点及鉴别诊断。方法 回顾分析 1876例食管鳞癌手术切除病例的临床资料 ,其中 9例诊断为BSCC ,对其临床资料及病理特点进行总结、分析。结果 食管BSCC主要发生于 5 0岁以上男性的中段食管 ,占食管鳞癌的 0 .48%。平均生存 17.6个月 ,2年生存率 2 2 .2 % ,与低分化鳞癌 ( 2年生存率 2 8.3 % )接近。形态学与腺样囊性癌 (ACC)或小细胞未分化癌 (SCC)有相似之处。 9例病例均可见癌与表面粘膜上皮移行过程 ,移行处粘膜上皮呈不典型增生、原位癌或鳞状上皮浸润癌。免疫组化染色与电镜检查有助于鉴别诊断。结论 食管BSCC为 1种形态特殊的高度恶性的鳞状细胞癌。
Objective To investigate the clinicopathological features and differential diagnosis of esophageal basal cell squamous cell carcinoma (BSCC). Methods The clinical data of 1876 cases of esophageal squamous cell carcinoma were reviewed retrospectively. Among them, 9 cases were diagnosed as BSCC, and their clinical data and pathological features were summarized and analyzed. Results The esophageal BSCC mainly occurred in the middle esophagus of men over 50 years old, accounting for 0. 48% of esophageal squamous cell carcinoma. The average survival was 17.6 months, and the 2-year survival rate was 22.2%, which was close to poorly differentiated squamous cell carcinoma (2-year survival rate of 28.3%). Morphology is similar to adenoid cystic carcinoma (ACC) or small cell undifferentiated carcinoma (SCC). Nine cases showed cancer and epithelial migration of the epithelial surface. The mucosal epithelium showed atypical hyperplasia, carcinoma in situ, or squamous epithelial invasive carcinoma. Immunohistochemical staining and electron microscopy help differential diagnosis. Conclusion Esophageal BSCC is a special form of highly malignant squamous cell carcinoma.