摘要
目的探讨INI1缺失性鼻腔鼻窦癌的临床病理学特征。方法收集2008~2021年广东省人民医院病理科诊断的185例原发性鼻腔鼻窦癌,采用免疫组化法检测INI1蛋白表达。对INI1表达缺失病例进一步行相关免疫组化和原位杂交检测。结果185例原发性鼻腔鼻窦癌中9例(4.9%)INI1表达缺失。患者年龄25~74岁,其中男性7例,女性2例。镜下见肿瘤由不同比例的基底样细胞和横纹肌样细胞组成,排列呈实性片巢状、条索状浸润性生长。肿瘤分期:8例为T4N0M0,1例为T4N1M0。8例患者获得随访,随访时间11~55个月,6例局部复发,2例远处转移;5例死亡。免疫表型:肿瘤细胞CK弥漫阳性,p63、p40、CK5/6、CK7和p16不同程度阳性。9例EBV和高危型HPV原位杂交检测结果均阴性。结论INI1缺失性鼻腔鼻窦癌是一种新近描述的高度侵袭性肿瘤,具有广泛的组织形态谱,行免疫组化检测(尤其INI1检测)有助于确诊。
Purpose To study the clinicopathologic features of INI1-deficient sinonasal carcinoma.Methods A total of 185 primary sinonasal carcinomas diagnosed between 2008 and 2021 were screened by immunohistochemistry for INI1.For cases that demonstrated loss of INI1 protein expression,additional immunohistochemistry staining and in situ hybridization assays were performed.Results Among the 185 sinonasal carcinomas,nine cases(4.9%)were negative for INI1,and classified as INI1-deficient sinonasal carcinoma.The patients comprised 7 males and 2 females with aged from 25 to 74 years(median:38 years).Histologically,the tumors comprised varying proportions of basaloid and rhabdoid cells,which were arranged in solid nests,cords and sheets within a desmoplastic stroma.The tumor stages were T4N0M0 in 8 cases and T4N1M0 in 1 case.During the follow-up ranging from 11 to 55 months(median:26 months),six patients developed local recurrences,and two patients experienced distant metastases.Ultimately,five patients died of the disease.Immunohistochemically,the tumors demonstrated an epithelial immunophenotype with diffuse positivity for cytokeratin and variable immunoreactivity for p63,p40,CK5/6,CK7 and p16.In situ hybridization assays revealed that all cases were negative for EBV and high-risk HPV infection.Conclusion INI1-deficient sinonasal carcinoma is a newly described and highly aggressive tumor with a wide histomorphologic spectrum.Comprehensive immunohistochemical analysis,especially the use of INI1 immunohistochemistry,may distinguish INI1-deficient sinonasal carcinoma from other poorly differentiated carcinomas of the sinonasal tract.
作者
刘驯骅
刘艳辉
李智
张明辉
LIU Xun-hua;LIU Yan-hui;LI Zhi;ZHANG Ming-hui(Department of Pathology,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)
出处
《临床与实验病理学杂志》
CAS
北大核心
2023年第3期326-330,共5页
Chinese Journal of Clinical and Experimental Pathology
