Adenosquamous carcinoma of the pancreas: A clinicopathologic series of 25 cases
Adenosquamous carcinoma of the pancreas: A clinicopathologic series of 25 cases
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DOI：
10.1038/modpathol.3880332
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发表时间：
2001-05-01
期刊：
影响因子：
7.5
通讯作者：
Heffess, CS
中科院分区：
文献类型：
--
作者：
Kardon, DE;Thompson, LDR;Heffess, CS
背景：腺鳞癌是胰腺癌的一种罕见的侵袭性亚型，我们描述了其中25例的临床、病理和分子特征，这是迄今为止最大的一系列病变。方法：从陆军病理研究所内分泌登记处检索1961~1994年间确诊的25例胰腺癌病例。回顾组织学特征，进行组织化学、免疫组织化学和分子(k-ras)研究，并获得患者随访。结果：男17例，女8例，年龄28~82岁，平均65.4岁。患者通常有体重减轻(n=17)或无痛性黄疸(n=ii)，同时还出现其他腹部症状。肿瘤累及头部最多(n=17)，其次为尾部(n=9)或身体(n=4)。5例累及胰腺多个解剖区域。显微镜下，所有肿瘤均表现为腺癌和鳞癌的双重分化。所有受试者均表达角蛋白(AE1：AE3和CK1)，而其他角蛋白标记物：CK5/6(88%)、CK7(68%)、Cam5.2(41%)和CK20(26%)表达不同。CA-19-9(84%)和CEA(74%)在大多数病例中阳性。13例中有7例发现K-ras癌基因突变。患者在确诊后平均5.8个月(1~33个月)死于疾病。结论：胰腺腺鳞癌是一种独特的临床和病理实体，表现出预期的免疫表型和k-ras癌基因突变，其起源于导管，预后比导管腺癌差。
Background: Adenosquamous carcinoma is a rare aggressive subtype of pancreatic adenocarcinoma, We describe the clinical, pathologic, and molecular characteristics of 25 of these lesions, the largest series to date. Methods: Twenty-five cases of adenosquamous carcinoma of the pancreas diagnosed between 1961 and 1994 were retrieved from the files of the Endocrine Registry of the Armed Forces Institute of Pathology. Histologic features were reviewed, histochemical, immunohistochemical, and molecular (k-ras) studies were performed, and patient follow-up was obtained. Results: The patients included 17 men and eight women, aged 28 to 82 years (mean, 65.4 y). The patients usually experienced weight loss (n = 17) or painless jaundice (n = II), while also presenting with other abdominal symptoms. The tumors affected the head most frequently (n = 17), followed by the tail (n = 9) or body (n = 4). Five cases involved more than one anatomic region of the pancreas. Microscopically, all tumors demonstrated dual differentiation toward adenocarcinoma and squamous cell carcinoma. All cases tested were immunoreactive with keratin (AE1:AE3 and CK1), whereas other keratin markers were variably expressed: CK5/6 (88%), CK7 (68%), Cam5.2 (41%), and CK20(26%). CA-19-9 (84%) and CEA (74%) were positive in the majority of the cases. K-ras oncogene mutations were identified in seven of 13 cases. AH patients died from their disease an average of 5.8 months after diagnosis (range, 1 to 33 months). Conclusions: Adenosquamous carcinoma of the pancreas represents a distinct clinical and pathologic entity, demonstrating the expected immunoprofile and k-ras oncogene mutation of a ductal origin, with a worse prognosis than ductal adenocarcinoma.