鼻腔HPV相关的鳞状细胞癌临床病理观察

Sinonasal HPV-related squamous cell carcinoma: clincopathological characteristics and prognosis

目的探讨鼻腔HPV相关的鳞状细胞癌的临床病理特征及预后。方法收集1例鼻腔HPV相关的鳞状细胞癌的临床资料,行HE染色、免疫组化及原位杂交检测,光镜下观察其形态学特点,并结合免疫组化和EBER原位杂交结果进行分析及随访。结果本例患者表现为间歇性左侧鼻堵。鼻腔镜表现为左侧中鼻甲肿物。肿瘤乳头状、质脆,镜下肿瘤细胞为非角化性或角化差。免疫组化:p16强(+),p53弱(+),Ki-67增殖指数为70%。原位杂交HPV6/11和HPV16/18(+),EBER(-)。结论 HPV相关的鳞状细胞癌是与HPV感染密切相关的特殊类型的鳞状细胞癌,组织学形态表现为非角化性鳞状细胞癌乳头状亚型,免疫表型独特,预后较好。

Objective To explore the clinical and pathological features of HPV-related squamous cell carcinoma through clinical case and literature review. Methods One case of sinonasal HPV-related squamous cell carcinoma was analyzed. The clinical data including clinical presentation and image changes were collected. The clinicopathological characteristics were evaluated by morphology,immunohistochemistry for p16,p53,Ki-67 and hybridization in situ for HPV6 /11 and HPV16 /18,EBER. The case was then followed-up after treatment. Results The tumor showed a spaceoccupying lesion of left middle turbinate with nasal obstruction. Grossly,the tumor was papillary like and fragile in endoscopic surgery. Microscopically,the tumor cells was non-keratinizing or poor-keratinizing. Immunohistochemically,the tumors cells were strong positive for p16,weak positive for p53,Ki-67 index was about 70%. In situ hybridization showed that the nuclei were positive for HPV6 /11 and HPV16 /18,and negative for EBER. Conclusion HPV-related squamous cell carcinoma is a special type of squamous cell carcinoma,which is closely related with HPV infection. It has a histological manifestation of papillary non-keratinizing and unique immunophenotype with better prognosis.