Differentiated dysplasia is a frequent precursor or associated lesion in invasive squamous cell carcinoma of the oral cavity and pharynx

被引:32
作者
Arsenic, Ruza [1 ,3 ]
Kurrer, Michael O. [2 ]
机构
[1] Cantonal Hosp Aarau, Inst Pathol, Aarau, Switzerland
[2] Univ Zurich, Zurich, Switzerland
[3] Univ Hosp Charite, Inst Pathol, D-10117 Berlin, Germany
关键词
Oropharyngeal cancer; Cancerprecursor lesions; Dysplasia; Differentiated dysplasia of squamous epithelium; PROLIFERATIVE VERRUCOUS LEUKOPLAKIA; VULVAR INTRAEPITHELIAL NEOPLASIA; HISTOLOGIC CLASSIFICATION; NATURAL-HISTORY; LICHEN-SCLEROSUS; PENILE CANCER; HYPERPLASIA; PROGRESSION; WEAKNESSES; DIAGNOSIS;
D O I
10.1007/s00428-013-1412-6
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The source of precursor lesions of squamous cell carcinoma (SCC) of the oral cavity and pharynx, their classification, and grading are controversial. In contrast, vulvar and penile cancer precursor lesions are known to be related to human papillomavirus or chronic inflammation and can be described using the vulvar intraepithelial neoplasia (VIN) classification system (VIN 1-3) or as differentiated vulvar intraepithelial neoplasia (dVIN), respectively. Oral and pharyngeal SCC precursor lesions are more etiologically diverse, and the spectrum of lesions may thus be wider. No international consensus exists regarding the histological types of precursor lesions or the significance of individual types. We therefore reviewed resection specimens and preceding biopsies of 155 patients with SCC of the oral cavity and pharynx (excluding tonsils) and identified five basic patterns of SCC-associated or precursor lesions: (1) pleomorphic (22/155), (2) basaloid (5/155), (3) differentiated (63/155), (4) mixed (42/155), and (5) verrucous (12/155). Keratinization was a common but variable feature in differentiated, mixed, and verrucous dysplasia. In 11/155 patients, no precursor lesion could be identified. Progression of isolated differentiated dysplasia (ranging from months to years) was documented in 13/155 (8 %) of patients. Our data suggest that full-thickness epithelial dysplasia of pleomorphic or basaloid type is present in < 20 % of oral and pharyngeal SCC, and differentiated dysplasia is a frequent precursor or associated in situ lesion. Failure to recognize differentiated dysplasia results in the underdiagnosis of many patients at risk for invasive carcinoma. These results indicate a need to refine criteria to distinguish differentiated dysplasia from morphologically related lichenoid lesions.
引用
收藏
页码:609 / 617
页数:9
相关论文
共 44 条
[1]  
Amagasa T, 2011, INT J CLIN ONCOL, V16, P5, DOI 10.1007/s10147-010-0157-3
[2]  
ANNEROTH G, 1984, SCAND J DENT RES, V92, P448
[3]   Proliferative verrucous leukoplakia: a concise update [J].
Bagan, J. ;
Scully, C. ;
Jimenez, Y. ;
Martorell, M. .
ORAL DISEASES, 2010, 16 (04) :328-332
[4]  
BAMFORD PN, 1983, ACTA CYTOL, V27, P482
[5]   Proliferative verrucous leukoplakia and its related lesions [J].
Batsakis, JG ;
Suarez, P ;
El-Naggar, AK .
ORAL ONCOLOGY, 1999, 35 (04) :354-359
[6]  
Bouquot JE., 2006, CURRENT DIAGNOSTIC P, V12, P11, DOI DOI 10.1016/J.CDIP.2005.10.008
[8]   Distribution and characterization of subtypes of penile intraepithelial neoplasia and their association with invasive carcinomas: a pathological study of 139 lesions in 121 patients [J].
Chaux, Alcides ;
Velazquez, Elsa F. ;
Amin, Ali ;
Soskin, Ana ;
Pfannl, Rolf ;
Rodriguez, Ingrid M. ;
Barreto, Jose E. ;
Lezcano, Cecilia ;
Ayala, Gustavo ;
Netto, George J. ;
Cubilla, Antonio L. .
HUMAN PATHOLOGY, 2012, 43 (07) :1020-1027
[9]   Diagnostic problems in precancerous lesions and invasive carcinomas of the penis [J].
Chaux, Alcides ;
Cubilla, Antonio L. .
SEMINARS IN DIAGNOSTIC PATHOLOGY, 2012, 29 (02) :72-82
[10]   Histological 'progression' from low (LSIL) to high (HSIL) squamous intraepithelial lesion is an uncommon event and an indication for quality assurance review [J].
Chen, Eleanor Y. ;
Tran, Ann ;
Raho, Caroline J. ;
Birch, Chandler M. ;
Crum, Christopher P. ;
Hirsch, Michelle S. .
MODERN PATHOLOGY, 2010, 23 (08) :1045-1051