原发结直肠鳞状细胞癌4例

Primary colorectal squamous cell carcinoma:report of four cases

目的探讨原发结直肠鳞状细胞癌临床病理特征及鉴别诊断。方法对4例原发结直肠鳞状细胞癌临床资料、组织形态及免疫组织化学进行分析。结果4例结直肠癌患者,2男2女,平均年龄48岁。发病部位:1例直肠,1例直肠与乙状结肠,1例横结肠,1例乙状结肠。组织学大体呈灰红色隆起性肿物,切面灰白灰红,质软;镜下癌细胞呈巢团状分布,可见单个细胞角化。免疫组织化学示:CK5/6、P63、P40、AE1/AE3等阳性,Syn、Cg A阴性,HPV阴性。结论原发结直肠鳞状细胞癌是一类少见恶性肿瘤,预后不良,诊断要结合影像学及病理活检排除转移可能后才可诊断。

Objective To investigate the clinicopathological characteristics and differential diagnosis of primary colorectal squamous cell carcinoma.Methods The clinical data,histomorphology and immunohistochemistry of 4 cases of primary colorectal squamous cell carcinoma were analyzed.Results There were 4 patients with colorectal cancer,2 men and 2 women,with an average age of 48 years.One case located in the rectum,1 case in both rectum and sigmoid colon,1 case in transverse colon and 1 case of sigmoid colon.Grossly,it showed a gray-red raised mass,the cut surface was gray-white and gray-red,soft in texture,and the cancer cells were distributed in nests under the microscope.Immunohistochemistry showed that CK5/6,P63,P40,AE1/AE3 were positive but Syn and Cg A were negative,and HPV was negative.Conclusion Primary colorectal squamous cell carcinoma is a rare type of malignant tumor with poor prognosis.The diagnosis should be combined with imaging and pathological biopsy to exclude the possibility of metastasis.