5例食管基底细胞样鳞状细胞癌组织化学及免疫组化观察

目的：探讨食管基底细胞样鳞状细胞癌(BSCC)的组织化学、免疫组化特征及在病理诊断中的作用方法：收集5例食管BSCC分别作HE、组织化学及免疫组化染色，同时收集5例典型鳞状细胞癌(SCC)作对照结果：BSCC主要由密集的小细胞组成，排列成实体小叶状及假腺样(筛网状)，并见粉刺样坏死及基底膜样物质沉积(PAS )，4例BSCC均见不同分化程度的鳞状细胞癌成分．1例见局灶性鳞状细胞分化免疫组化基底细胞样成分Ker(AE1／AE3)、Ker14、PCNA、LM及p53均阳性，Ker194例基底细胞样成分及2例伴随鳞癌成分同时阳性：Syn仅1例BSCC阳性；5例SCC Ker(AE1／AE3)均阳性．3例Ker14弱阳性，2例Ker19弱阳性5例BSCC和BCC其S-100、CgA、NSE及SMA均阴性。结论：BSCC是鳞状细胞癌独特的组织学类型，进行组织化学及免疫组化染色有助于BSCC诊断及鉴别诊断。

A Histochemical and Immunohistochemical Observation of Basaloid Squamous Cell Carcinoma in the Esophagus

Objective:To study the clinical-pathological characteristics and the diagnostic crite ria of basaloid squamous cell carcinoma(BSCC)of the esophagus.Methods:5cases of BSCC of the esophagus were stained with hematoxylin and eosin (HE)?histochemical and immunohist-ochemical methods.At the same time,5cases of typical squamous cell carcinoma (SCC)were stud ied.Results:BSCC was composed of relatively small tumor cells,arrarged in solid lobules(or crib riform)pseudoglandular spaces with abundant comedo-type necrosis and basal membrane-like meterial deposition within the stroma (PAS+).Four cases were accompanied by areas of typ ical squamous cell carcinoma(SCC).Immunohistochemicaly,Ker(AE1/AE3)?Ker14?laminin(LM)?PC-NA and p53were positive in all cases?Ker19in4cases and synaptophysin(Syn)in one BSCC case.Ker(AE1/AE3)were postive in5cases of SCC,Ker14were weak postive in3cases of SCC and Ker19in2cases of SCC.S-100,chromogranin(CgA)?neuronal specific endolase(NSE)and smooth muscle actin(SMA)were negative in all BSCC and SCC.Conclusion:BSCC is a dis tinct histopathologic variant of SCC.A histochemical and immunohisto chemical stains assist in diagnosis of basaloid squamous cell carcinoma(BSCC)in the esophagus.