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目的观察阴茎腺鳞癌的临床表现和病理特点,研究其免疫表型及与人类乳头状瘤病毒(HPV)的相关性。方法观察手术切除的1例阴茎腺鳞癌,评价其组织形态学特点和免疫表型,并用原位杂交法检测肿瘤内HPV感染情况。结果肿瘤在龟头部浸润性生长,无菜花或疣状病变,冠状沟处有浅溃疡形成。镜下见低分化鳞癌形成的实性癌巢和细胞质内有黏液形成的腺癌,AB-PAS染色见腺癌瘤细胞质内大部分为中性黏液,少量为酸性黏液。免疫组化显示癌组织CK和EMA强(+),其中鳞状细胞癌CK5和p63强(+),腺癌CK7强(+),GCDFP-15、CD15和S-100散在(+),bcl-2(-)。HPV原位杂交(-)。患者病情进展迅速,3个月即出现双侧腹股沟淋巴结转移。结论阴茎腺鳞癌是原发性阴茎恶性肿瘤中罕见类型,易误诊为炎症,但具有高度侵袭性,可早期发生转移,与HPV感染无关。
Objective To observe the clinical manifestations and pathological features of penile adenosquamous carcinoma and to investigate its immunophenotype and its relationship with human papillomavirus (HPV). Methods One case of penis adenosquamous carcinoma of the penis was observed. The histomorphology and immunophenotype were evaluated. In situ hybridization was used to detect HPV infection in the tumor. Results The tumor in the glans head invasive growth, non-cauliflower or verrucous lesions, coronary ulcer at the formation of shallow ulcers. Microscopically, poorly differentiated squamous cell carcinoma formed by solid cancer and cytoplasm of mucus-forming adenocarcinoma, AB-PAS staining, most of adenocarcinoma cytoplasm is a neutral mucus, a small amount of acidic mucus. Immunohistochemistry showed that CK and EMA were strongly (+) in squamous cell carcinoma, including squamous cell carcinoma CK5 and p63 (+), adenocarcinoma CK7 (+), GCDFP-15, CD15 and S-100 scattered -2(-). HPV in situ hybridization (-). The patient’s condition progressed rapidly, bilateral inguinal lymph node metastasis occurred in 3 months. Conclusions Penile adenosquamous carcinoma is a rare type of primary malignant tumor of penis. It is easily misdiagnosed as inflammation, but it is highly invasive and can metastasize early. It has nothing to do with HPV infection.