食管梭形细胞癌临床病理分析

目的分析食管梭形细胞癌的临床病理特点,探讨其组织来源。方法回顾性分析4例食管梭形细胞癌的临床病理资料及复习有关文献。结果 4例患者为男性,1例为女性,平均年龄57.2岁,病变位于食管中下段,大体呈息肉型、髓质型、蕈伞型及溃疡型。显微镜下可见鳞状细胞癌和肉瘤样成份,其中3例未找到两者相移行的区域。免疫组织化学检查发现肉瘤样区域细胞中有AE1/AE3、vimentin蛋白表达,息肉型者软骨肉瘤样区域仅有Vimentin和S-100蛋白表达,纤维肉瘤成份仅有vimentin蛋白表达。结论食管梭形细胞癌本质上是1种特殊类型的癌,包括肉瘤样癌和癌肉瘤。肉瘤样癌区域可能是癌细胞双向分化的结果,癌肉瘤的发生机制有待于进一步研究。

Clinicopathological Study of Spindle Cell Squamous Carcinoma of the Esophagus

Objective To investigate the clinicopathological characters of spindle cell sqamous carcinoma of the esophagus,in order to understand the histogenesis of this tumor.Methods The clinical data,pathological changes of 5 cases with spindle cell sqamous carcinoma were retrospectively analyzed.Results There were 4 males and 1 female.The mean age was 57.2 years old.The tumors were located in the middle or low part of esophagus,and the gross pattern of the tumors appeared typically polypoid,medullary,fangating or ulcerative.Microscopically the tumors were composed of squamous cell carcinoma and sarcoma-like elements,while transitional features were not observed in 3 cases.Immunohistochemical examination disclosed positive expression of AE1/AE3 protein and vimentin protein in Sarcoma-like spindle cells.Specially,sarcomatous cells of the polypoid tumor in the condrosarcoma-like area only expressed vimentin protein and S-100 protein.In the fibrosarcoma zone,the tumor cell only expressed vimentin.Conclusion Spindle cell squamous carcinoma is a special type of carcinoma,which includes sarcomatoid carcinoma and carcinosarcoma.Sarcoma-like component of the spindle cell squamous carcinoma of the esophagus may be the result of a bi-directional differentiation of the malignant epithelial cells.The pathogenesis of carcinosarcoma needs further study.