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目的 了解食管基底细胞样鳞状细胞癌 (BSC)的生物学特点。方法 食管基底细胞样鳞状细胞癌 8例 ,用CK4 ,CK18,CK19,EMA ,CEA ,α SMA ,S 10 0 ,LN ,Col Ⅳ ,NSE ,PCNA ,p5 3等 12种抗体进行免疫组化常规ABC法检测。结果 BSC的两种细胞成分 ,即基底样细胞 (BC)和鳞状细胞 (SC)对上述抗体反应截然不同。绝大部分病例 (7例 )BC专一地对CK19抗体呈阳性反应 ,而对其它 4种上皮性抗体呈阴性反应 ;有 4例BC对α SMA及S 10 0肌性抗体呈阳性 ;BC巢内玻璃样物对LN及Col Ⅳ呈阳性反应 ;BC有较高的PCNA指数 ,平均为 5 4 %。相反 ,7例SC成分均对CK4、CEA、EMA等上皮性抗体呈阳性 ;对CK19、α SMA、S 10 0呈阴性 ;PCNA指数较低 ,平均为 2 5 %。结论 食管BSC为多向分化的高度恶性肿瘤。BC代表向基底细胞和肌上皮方向分化 ,其增殖活性强 ;而SC代表向典型的鳞状细胞分化。
Objective To understand the biological characteristics of esophageal basal cell-like squamous cell carcinoma (BSC). Methods Esophageal basal cell-like squamous cell carcinoma was performed in 8 cases and immunohistochemistry was performed with 12 antibodies including CK4, CK18, CK19, EMA, CEA, α SMA, S 10 0, LN, Col IV, NSE, PCNA, and p53. ABC test. Results The two cellular components of BSC, basal-like cells (BC) and squamous cells (SC), reacted differently to these antibodies. In most cases (7 cases), BC specifically responded positively to CK19 antibody but negatively to the other 4 epithelial antibodies; 4 cases of BC were positive to α SMA and S 10 0 muscle antibodies; BC nests The inner glass-like material was positive for LN and Col IV; BC had a higher PCNA index, with an average of 54 %. In contrast, 7 SC components were all positive for epithelial antibodies such as CK4, CEA, EMA; negative for CK19, α SMA, S 10 0; PCNA index was low, with an average of 25%. Conclusion Esophageal BSC is a highly malignant tumor with multiple differentiation. BC represents differentiation towards basal cells and myoepithelial cells with strong proliferative activity, while SC represents differentiation into typical squamous cells.