Immunohistochemical and oncogenetic analyses of the esophageal basaloid squamous cell carcinoma in comparison with conventional squamous cell carcinomas
Immunohistochemical and oncogenetic analyses of the esophageal basaloid squamous cell carcinoma in comparison with conventional squamous cell carcinomas
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DOI：
10.1016/j.humpath.2012.02.010
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发表时间：
2012-11-01
期刊：
影响因子：
3.3
通讯作者：
Yao, Takashi
中科院分区：
文献类型：
--
作者：
Imamhasan, Abdukadir;Mitomi, Hiroyuki;Yao, Takashi
食管基底样鳞状细胞癌是鳞状细胞癌的一种罕见变异。我们回顾了 878 例食管鳞状细胞癌病例，发现 22 例（3%）基底细胞样鳞状细胞癌。研究人员对这些肿瘤和分期匹配的常规鳞状细胞癌的临床病理特征和细胞角蛋白亚型、p53、B 细胞淋巴瘤 2 (bcl-2)、β-连环蛋白和表皮生长因子受体的免疫反应性进行了研究。还测定了 p53、CTNNB1（编码 β-连环蛋白的基因）和表皮生长因子受体 (EGFR) 的分子畸变。基底细胞样鳞状细胞癌患者的 5 年生存率为 42%，明显低于高分化鳞状细胞癌患者 (P < .01)。组织学上，几乎所有 (>= 95%) 病例均发现具有中央坏死和筛状模式的实性巢，导管分化频率较低 (45%)，但与显着更好的存活率相关 (P < .05)。与传统鳞状细胞癌相比，基底样鳞状细胞癌对细胞角蛋白 14、细胞角蛋白 903 和膜 β-连环蛋白的免疫反应性较低 (P < .01-.001)，但对 bcl-2、核 β-连环蛋白、表皮生长因子受体和 Ki-67 的免疫反应性更高 (P < .05-.001)。直接测序显示 p53 (36%)、EGFR (14%) 突变，但没有 CTNNB1 突变；荧光原位杂交检测到表皮生长Actor受体基因扩增（22%）。在基底样鳞状细胞癌中，细胞角蛋白 14/细胞角蛋白 903 的低水平表达以及 p53 和 EGFR 的突变对较差的生存率具有显着影响 (P < .05-.001)。我们的结论是，食管基底样鳞状细胞癌是一种具有特别侵袭性生物学行为的肿瘤，应与常规鳞状细胞癌相鉴别。在这种情况下，几种标记物的免疫组织化学评估可能提供有用的辅助诊断工具。 p53 和表皮生长因子受体基因的异常可能与食管基底样鳞状细胞癌的进展有关。 (C) 2012 Elsevier Inc. 保留所有权利。
Basaloid squamous cell carcinoma of the esophagus is a rare variant of squamous cell carcinoma. We reviewed 878 cases of esophageal squamous cell carcinoma and detected 22 cases (3%) of basaloid squamous cell carcinoma. These tumors and stage-matched paired conventional squamous cell carcinomas were investigated for clinicopathologic features and immunoreactivity of cytokeratin subtypes, p53, B-cell lymphoma 2 (bcl-2), beta-catenin, and epidermal growth factor receptor. Molecular aberrations in p53, CTNNB1 (the gene encoding beta-catenin), and epidermal growth factor receptor (EGFR) were also determined. Patients with basaloid squamous cell carcinomas demonstrated a 5-year survival rate of 42%, significantly worse than those with well-differentiated squamous cell carcinoma (P < .01). Histologically, solid nests with central necrosis and a cribriform pattern were identified in almost all (>= 95%) cases, and ductal differentiation was less frequent (45%) but associated with significantly better survival (P < .05). Compared with conventional squamous cell carcinomas, the basaloid squamous cell carcinomas were less immunoreactive for cytokeratin 14, cytokeratin 903, and membranous beta-catenin (P < .01-.001) but more reactive for bcl-2, nuclear beta-catenin, epidermal growth factor receptor, and Ki-67 (P < .05-.001). Direct sequencing showed mutations of p53 (36%), EGFR (14%), but not CTNNB1; fluorescent in situ hybridization detected amplification of the epidermal growth Actor receptor gene (22%). In basaloid squamous cell carcinomas, low-level expression of cytokeratin 14/cytokeratin 903 and mutations of p53 and EGFR had a significant influence on worse survival (P < .05-.001). We conclude that the esophageal basaloid squamous cell carcinoma, a neoplasm with particularly aggressive biologic behavior, should be differentiated from conventional squamous cell carcinomas. In this context, immunohistochemical assessment of several markers might provide a useful adjunct diagnostic tool. Aberrations of p53 and epidermal growth factor receptor genes are possibly involved in progression of esophageal basaloid squamous cell carcinoma. (C) 2012 Elsevier Inc. All rights reserved.