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目的 研究食管基底细胞样鳞癌病理特征 ,探讨其病变性质、诊断及鉴别诊断。方法 应用形态学、组织化学 (AB/PAS)和免疫组织化学方法 (S P法 ) ,对 10例男性食管BSC患者进行病理形态学观察和多种抗体免疫组织化学检测。结果 癌瘤显示基底细胞和鳞状细胞双相型癌肿成分。基底细胞样癌多呈实体分叶状 (10 0 .0 % )、巢索状 (80 .0 % )、指突状 (5 0 .0 % )、巢周栅状 (90 .0 % )排列 ,巢中央有特征性粉刺型坏死 (80 .0 % ) ,间质有基膜样物质沉积和玻璃样变 (80 .0 % )。鳞状细胞样癌呈原位癌、片状、单个细胞角化或角化珠镶嵌于基底细胞样癌中 ,易见脉管瘤栓 (80 .0 % )和核分裂像 (35～ 10 0个 /10HPF)。多数病例免疫组织化学Ki 6 7、PCNA、CK (AE1/AE 3)、CK 14、CK 19呈阳性表达 ,SC、CHG A、Syn、S 10 0 、α SMA则多呈阴性表达 ,但缺乏诊断特异性。结论 食管BSC系鳞癌的 1种特殊亚型 ,其生物学行为具有与低分化鳞癌相似或更强的侵袭行为和更差的预后特征。
Objective To study the pathological features of esophageal basal cell-like squamous cell carcinoma and explore its nature, diagnosis and differential diagnosis. METHODS: Morphological, histochemical (AB/PAS) and immunohistochemistry (S P method) were used to examine pathomorphology and multiple antibody immunohistochemistry in 10 male esophageal BSC patients. Results Carcinoma showed biphasic cancerous components of basal cells and squamous cells. Basal cell-like carcinomas were mostly lobulated (10 0.0%), nested (80.0 %), fingerlike (50%), and nested (90.0.0%). There was a characteristic acne necrosis in the center of the nest (80.0%), and there was a deposition of basement membrane-like material and a hyaline change (80.0%) in the interstitium. Squamous cell carcinomas are carcinomas in situ, lamellae, keratinization of single cells, or keratinized beads in basal cell-like carcinomas. Vascular tumor thrombi (80.0%) and mitoses (35 to 100) are easily seen. /10HPF). In most cases, immunohistochemistry Ki 67, PCNA, CK (AE1/AE 3), CK 14, CK 19 were positive expression, SC, CHG A, Syn, S 10 0, α SMA were mostly negative expression, but the lack of diagnosis Specificity. Conclusions There is a special subtype of squamous cell carcinoma of the squamous cell of the esophageal squamous cell carcinoma. Its biological behavior has similar or stronger invasive behavior and worse prognosis than poorly differentiated squamous cell carcinoma.