喉梭形细胞鳞状细胞癌的临床病理特点分析

Clinicopathologic characteristics of laryngeal spindle-cell squamous carcinoma

目的 总结和分析喉梭形细胞鳞状细胞癌(spindle cell squamous carcinoma,Spc-SCC)的临床及病理特点,以期加深临床对该肿瘤的的认识,提升诊疗水平。方法 回顾性分析2017年4月~2021年4月于首都医科大学附属北京同仁医院耳鼻咽喉头颈外科诊治的12例Spc-SCC患者临床表现、病理及预后资料,10例行单纯手术治疗,1例术后行放、化疗,1例单纯放疗。利用SPSS软件,Kaplan-Meier法行统计学分析。结果 10例病理标本中可见梭形细胞/肉瘤样成分和上皮细胞成分共存,以梭形细胞成分为主,2例仅见梭形细胞成分。免疫组化染色均可见角蛋白CK的表达。随访3~63个月,2例患者死亡,1例死于局部复发大出血,1例为仅行放疗患者,余10例患者截至随访结束未见肿瘤复发及转移征象。1年、3年、5年生存率分别为91.7%、83.3%、83.3%。结论 病理学检查是Spc-SCC的主要确诊方式,手术切除为其主要的治疗手段。

OBJECTIVE To summarize and analyze the clinical and pathological features of laryngeal spindle cell squamous cell carcinoma in order to deepen the clinical understanding of the tumor and improve the level of diagnosis and treatment.METHODS The clinical,pathological and prognostic data of 12 cases of laryngeal spindle-cell cell squamous cell carcinoma treated in Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital from April 2017 to April 2021 were retrospectively analyzed.Ten cases received surgery treatment only,1 case received postoperative radiotherapy and chemotherapy,and one case received radiotherapy alone.Statistical analysis was performed by Kaplan-Meier method using SPSS software.RESULTS Of the 12 cases of laryngeal spindle-cell squamous cell carcinoma,10 cases showed spindle cell/sarcomatoid components and epithelial cell components,mainly spindle cell components,the other 2 cases only spindle cell components.Immunohistochemical staining showed keratin CK expression.During 3 to 63 months of follow-up,2 patients died,1 died of local recurrence,and the another one was the patient who was treated by radiotherapy only.The remaining 10 patients showed no signs of tumor recurrence and metastasis by the end of follow-up.The 1-year survival rate was 91.7%,and the 3-year and 5-year average was 83.3%.CONCLUSION Pathological examination is the main diagnosis method of laryngeal spindle-cell squamous cell carcinoma and surgical resection is still the main treatment.