【摘要】 目的 探讨直肠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10例直肠BSCC分别作HE、组织化学及免疫组化染色，同时收集10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+)，8例BSCC均见不同分化程度的鳞状细胞癌成分，2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，Ker19，8例基底细胞样成分及4例伴随鳞癌成分同时阳性；Syn仅2例BSCC阳性，10例SCC Ker(AE1、AE3)均阳性，6例Ker14弱阳性，4例Ker19弱阳性。10例BSCC和BCC其S100、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。

    【关键词】 直肠肿瘤 基底细胞样鳞状细胞癌 诊断 免疫组化

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

    Wang Shifeng,et al.

    (People’s Hospital of Linyi,Linyi,Shandong 26000 China)

    【Abstract】 Objective To study the clinical-pathological characteristics and the diagnostic criteria of basaloid squamous cell carcinoma(BSCC) of the rectum.Methods 10 cases of BSCC of the rectum were stained with hematoxylin and eosin (HE)、histochemical and immunohistochemical methods.At the same time,10 cases of typical squamous cell carcinoma (SCC) were studied.Results BSCC was composed of relatively small tumor cells,arranged in solid lobules (orcribriform) pseudoglandular spaces with abundant comedo-type necrosis and basal membrane-like metrial deposition within the stroma (PAS+).8 cases were accompanied by areas of typical squamous cell carcinoma(SCC).Immunohistochemicaly,Ker(AE1/AE3)、Ker14、laminin(LM)、PCNA and p53 were positive in all cases、Ker19 in 8 cases and synaptophysin(Syn) in 2 BSCC case.Ker(AE1/AE3) were postive in 10 cases of SCC.Ker14 were weak postive in 6 cases of SCC and Kre19 in 4 cases of SCC.S-100,chromogranin(CgA)、neuronal specific endoplasm (NSE) and smooth muscle actin(SMA) were negative in al BSCC and SCC.Conclusions BSCC is a distinct histopathologic variant of SCC.A histochemical and immunohistochemical stains assist in diagnosis of basaloid squamous cell carcinoma(BSCC) in the esophagus. ......