Squamous cell carcinoma(SCC)of the rectum is a rare disease.A 59-year-old man presented with SCC of the middle rectum located 10 cm from the anus.The stage of the tumor was revealed to be T3N+M0.The patient received a...Squamous cell carcinoma(SCC)of the rectum is a rare disease.A 59-year-old man presented with SCC of the middle rectum located 10 cm from the anus.The stage of the tumor was revealed to be T3N+M0.The patient received a combined treatment with cisplatin and fluorouracil in concomitance with external radiation therapy.He then underwent an anterior resection of the rectum.The postoperative histopathological findings classified the tumor as yp T0N0 with cancer-free margins and lymph nodes.Treatment of SCC remains very challenging,and the acquisition of more consistent data is needed.展开更多
AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items ...AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC's are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-nodemetastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external siteof primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease.展开更多
在联合抗逆转录病毒治疗(combined antiretroviral therapy,cART)普及之前,1型人类免疫缺陷病毒(type one human immunodeficiency virus,HIV-1)感染者主要患艾滋病定义癌症,如卡波西肉瘤和非霍奇金淋巴瘤。然而,自cART广泛普及之后,艾...在联合抗逆转录病毒治疗(combined antiretroviral therapy,cART)普及之前,1型人类免疫缺陷病毒(type one human immunodeficiency virus,HIV-1)感染者主要患艾滋病定义癌症,如卡波西肉瘤和非霍奇金淋巴瘤。然而,自cART广泛普及之后,艾滋病定义癌症的发病率和病死率显著降低,而非艾滋病定义癌症如乳腺癌、肝癌、结直肠癌等成为导致HIV-1感染者病死率升高的主要原因。小细胞癌(small cell carcinoma,SCC)是一种起源于神经内分泌细胞的恶性肿瘤,具有生长迅速、早期扩散、预后差的特点,以肺最多见,而甚少发生在胃肠道。结直肠SCC是结直肠肿瘤中一种罕见类型,占全部结直肠肿瘤的1%以下,其总体病死率极高。有关HIV-1感染合并直肠SCC的国内外文献非常有限,本文报告1例HIV-1感染合并原发直肠SCC患者的临床资料,并进行相关文献复习,以期为该类疾病的诊断和治疗提供新的思路。展开更多
目的探讨细胞S期激酶相关蛋白(SKP2)和P27K ip l蛋白在直肠癌中的表达及与直肠癌各项临床病理特征的关系,并探讨两者的相关性。方法用免疫组化EnvisionTM法检测62例直肠癌中SKP2和P27K ip l蛋白的表达。结果62例直肠癌组织中P27K ip l、...目的探讨细胞S期激酶相关蛋白(SKP2)和P27K ip l蛋白在直肠癌中的表达及与直肠癌各项临床病理特征的关系,并探讨两者的相关性。方法用免疫组化EnvisionTM法检测62例直肠癌中SKP2和P27K ip l蛋白的表达。结果62例直肠癌组织中P27K ip l、SKP2蛋白的表达率分别为46.77%、33.87%。随肿瘤分化程度降低、浸润深度加深、淋巴结转移和临床分期提高,P27K ip l蛋白表达率逐渐降低(P<0.05);SKP2的表达率随肿瘤分化降低和浸润深度加深而逐渐升高。两者的阳性表达率均与患者的年龄、性别、肿瘤大小无关(P>0.05)。P27K ip l与SKP2表达呈显著负相关(P<0.01)。结论P27K ip l、SKP2的异常表达可加速细胞周期转化,促进直肠癌的发生。对两种蛋白的检测有助于直肠癌恶性程度和预后的判断。展开更多
文摘Squamous cell carcinoma(SCC)of the rectum is a rare disease.A 59-year-old man presented with SCC of the middle rectum located 10 cm from the anus.The stage of the tumor was revealed to be T3N+M0.The patient received a combined treatment with cisplatin and fluorouracil in concomitance with external radiation therapy.He then underwent an anterior resection of the rectum.The postoperative histopathological findings classified the tumor as yp T0N0 with cancer-free margins and lymph nodes.Treatment of SCC remains very challenging,and the acquisition of more consistent data is needed.
文摘AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC's are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-nodemetastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external siteof primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease.
文摘在联合抗逆转录病毒治疗(combined antiretroviral therapy,cART)普及之前,1型人类免疫缺陷病毒(type one human immunodeficiency virus,HIV-1)感染者主要患艾滋病定义癌症,如卡波西肉瘤和非霍奇金淋巴瘤。然而,自cART广泛普及之后,艾滋病定义癌症的发病率和病死率显著降低,而非艾滋病定义癌症如乳腺癌、肝癌、结直肠癌等成为导致HIV-1感染者病死率升高的主要原因。小细胞癌(small cell carcinoma,SCC)是一种起源于神经内分泌细胞的恶性肿瘤,具有生长迅速、早期扩散、预后差的特点,以肺最多见,而甚少发生在胃肠道。结直肠SCC是结直肠肿瘤中一种罕见类型,占全部结直肠肿瘤的1%以下,其总体病死率极高。有关HIV-1感染合并直肠SCC的国内外文献非常有限,本文报告1例HIV-1感染合并原发直肠SCC患者的临床资料,并进行相关文献复习,以期为该类疾病的诊断和治疗提供新的思路。
文摘目的探讨细胞S期激酶相关蛋白(SKP2)和P27K ip l蛋白在直肠癌中的表达及与直肠癌各项临床病理特征的关系,并探讨两者的相关性。方法用免疫组化EnvisionTM法检测62例直肠癌中SKP2和P27K ip l蛋白的表达。结果62例直肠癌组织中P27K ip l、SKP2蛋白的表达率分别为46.77%、33.87%。随肿瘤分化程度降低、浸润深度加深、淋巴结转移和临床分期提高,P27K ip l蛋白表达率逐渐降低(P<0.05);SKP2的表达率随肿瘤分化降低和浸润深度加深而逐渐升高。两者的阳性表达率均与患者的年龄、性别、肿瘤大小无关(P>0.05)。P27K ip l与SKP2表达呈显著负相关(P<0.01)。结论P27K ip l、SKP2的异常表达可加速细胞周期转化,促进直肠癌的发生。对两种蛋白的检测有助于直肠癌恶性程度和预后的判断。
