Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (1): 62-67. doi: 10.19723/j.issn.1671-167X.2022.01.010

Previous Articles     Next Articles

Clinicopathological study in 28 cases of oral basaloid squamous cell carcinomas

ZHOU Chuan-xiang,ZHOU Zheng,ZHANG Ye,LIU Xiao-xiao,GAO Yan()   

  1. Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2021-10-12 Online:2022-02-18 Published:2022-02-21
  • Contact: Yan GAO E-mail:gaoyan0988@163.com
  • Supported by:
    Beijing Nature Science Foundation(7192232)

RICH HTML

 13   

PDF (PC)

160

Abstract:

Objective: To investigate the clinicopathologic features and prognostic factors in oral basaloid squamous cell carcinoma. Methods: Retrospective analysis of oral basaloid squamous cell carcinomas patients who underwent tumor resection during the period from January 2002 to December 2020 in the authors’ hospital, especially the clinicopathologic characteristics of 28 cases with confirmed diagnosis and follow-up data. Immunohistochemistry was performed to define the helpful markers for differentiation diagnosis. The factors influencing the prognosis were evaluated based on Kaplan-Meier method. Results: The tongue and mouth floor (11 cases, 39.3%) were the most frequently involved sites, followed by gingiva (6 cases, 21.4%), buccal (5 cases, 17.9%), palate (4 cases, 14.3%), and oropharynx (2 cases, 7.1%). The majority of basaloid squamous cell carcinomas were in advanced stage, with 12 cases in stage Ⅱ and 16 cases in stages Ⅲ-Ⅳ. Twelve of 28 patients were identified to have cervical lymph node metastasis, which was confirmed by histopathological examination. The incidence rate of lymph node metastasis was 42.9% (12/28). Nine tumors recurred, with one metastasized to the lung. At the meantime, the 28 conventional squamous cell carcinomas were matched with the same stage, among which 13 cases were identified with cervical lymph node metastasis. The incidence rate of lymph node metastasis was 46.4% (13/28). Five cases recurred, with two cases that metastasized to the lung and one to the brain. The 5-year overall survival rates of the basaloid squamous cell carcinoma and conventional squamous cell carcinoma patients were 54.6% and 53.8%, respectively. Histopathologically, basaloid cells consisted of tumor islands without evident keratinization but frequently with comedo-like necrosis within the tumor islands. CK5/6 and P63 exhibited strongly positive in all the 28 cases, whereas neuroendocrine markers, CgA and Syn, were negative. Eight cases positively expressed P16; one case showed focal SOX10 positive but CK7 negative. Conclusion: The majority of oral basaloid squamous cell carcinomas present in advanced stage with a high tendency to lymph node metastasis, but the overall survival rates are not significantly different from conventional squamous cell carcinomas matched with the same stage. The human papilloma virus (HPV),as HPV-positivity rate is high, correlates to good prognosis. In addition, CK7 & SOX10 immunohistochemistry could contribute to differential diagnosis for basaloid squamous cell carcinoma with solid adenoid cystic carcinoma.

Key words: Squamous cell carcinoma, Adenoid cystic carcinoma, P16, Human papilloma virus

CLC Number: 

  • R780.2

Table 1

The clinicopathologic features of the patients with BSCC and conventional SCC"

Case
no.		 BSCC Case
no.		 SCC
Agea/
gender		 Location Stage LN
metastasis		 Follow-up P16
IHC		 Agea/
gender		 Location Stage LN
metastasis		 Follow-up P16
IHC
1 77/M Palate Ⅲ + Dead/3 y - 1 67/M Palate Ⅲ - Alive/5 y +
2 71/M Tongue Ⅱ - Alive/11 y + 2 73/M Tongue Ⅱ - Alive/4 y -
3 57/M Floor of mouth Ⅳ + Alive/9 y + 3 48/M Floor of mouth Ⅳ + Alive/4 y +
4 70/M Gingiva Ⅱ - Alive/6 y + 4 68/F Gingiva Ⅱ - Alive/5 y -
5 62/M Oropharynx Ⅱ - Dead/4 y - 5 38/M Oropharynx Ⅱ - Alive/3 y -
6 75/F Buccal Ⅱ - Alive/5 y - 6 81/F Buccal Ⅱ - Dead/2.5 y -
7 60/M Gingiva Ⅱ - Dead/1 y - 7 46/M Gingiva Ⅱ - Alive/4 y -
8 33/F Palate Ⅱ - Alive/5 y + 8 71/M Palate Ⅱ - Alive/2 y -
9 58/M Gingiva Ⅱ - Alive/5 y + 9 62/M Gingiva Ⅱ - Dead/2 y +
10 60/M Gingiva & buccal Ⅳ - Dead/2 y - 10 79/M Gingiva Ⅳ + Dead/4 y -
11 52/M Floor of mouth
& Tongue		 Ⅳ + Alive/3 y - 11 54/M Floor of mouth Ⅳ + Alive/4 y -
12 67/M Gingiva Ⅳ - Alive/3 y - 12 71/F Gingiva Ⅳ + Dead/1.5 y -
13 41/M Palate Ⅲ + Alive/2 y - 13 56/M Palate Ⅲ - Alive/2 y -
14 53/M Floor of mouth Ⅳ + Alive/1.5 y - 14 60/M Floor of mouth Ⅳ + Dead/3 y -
15 68/M Tongue Ⅱ - Alive/1 y - 15 64/F Tongue Ⅱ - Alive/4 y -
16 60/M Floor of mouth Ⅲ + Alive/1 y - 16 74/M Floor of mouth Ⅲ - Dead/1 y -
17 62/M Tongue Ⅳ + Dead/2 y - 17 71/F Tongue Ⅳ + Dead/2.5 y -
18 51/M Gingiva Ⅳ - Alive/1 y - 18 73/F Gingiva Ⅳ + Dead/2.5 y +
19 67/M Floor of mouth Ⅱ - Alive/1 y - 19 52/M Floor of mouth Ⅱ - Alive/4 y -
20 58/M Buccal Ⅲ + Alive/2 y - 20 43/M Buccal Ⅲ + Alive/3 y +
21 39/M Tongue Ⅱ - Alive/1.5 y - 21 66/M Tongue Ⅱ - Alive/5 y -
22 34/M Palate Ⅲ + Alive/4 y + 22 62/M Palate Ⅲ + Alive/3 y -
23 57/M Oropharynx Ⅳ - Alive/1 y + 23 64/M Oropharynx Ⅳ + Dead/1 y -
24 58/M Buccal Ⅱ - Alive/2.5 y - 24 66/M Buccal Ⅱ - Dead/3 y -
25 66/M Buccal Ⅳ + Dead/3 y - 25 53/M Buccal Ⅳ + Alive/3 y +
26 44/F Tongue Ⅲ + Dead/3 y - 26 52/F Tongue Ⅲ + Alive/4 y -
27 47/M Gingiva Ⅱ - Alive/3 y + 27 72/M Gingiva Ⅲ - Dead/2 y -
28 50/M Floor of mouth Ⅳ + Dead/2 y - 28 76/M Floor of mouth Ⅳ + Dead/2 y -

Figure 1

Pathological features of BSCC A, basaloid tumor cells showing solid growth with central comedo-like necrosis (HE ×100); B, basaloid cells with high nucleocytoplasmic ratio and prominent mitotic figures (HE ×200); C, basaloid cells showing a cribriform-like pattern (HE ×100); D, BSCC lymph node metastasis pattern (HE ×40); BSCC, basaloid squamous cell carcinoma."

Figure 2

Immunohistochemical staining in BSCC A, positive immunostaining for P16 in BSCC (IHC ×100); B, positive immunostaining for P16 in BSCC (IHC ×200); C, positive immunostaining for AR in BSCC (IHC ×200); D, high expression of Ki-67 in BSCC (IHC ×200); E, negative immunostaining for CK7 in basaloid tumor cells (IHC ×100); F, negative immunostaining for SOX10 in basaloid tumor cells (IHC ×100); BSCC, basaloid squamous cell carcinoma; IHC, immunohistochemistry."

Figure 3

Kaplan-Meier analysis of BSCC and conventional SCC A, comparison of survival curves between patients with BSCC and conventional SCC; B, comparison of survival curves between patients with P16 positive and negative; BSCC, basaloid squamous cell carcinoma; SCC, squamous cell carcinoma."

[1] Wain SL, Kier R, Vollmer RT, et al. Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases[J]. Hum Pathol, 1986, 17(11):1158-1166.
pmid: 3770734
[2] Paulino AF, Singh B, Shah JP, et al. Basaloid squamous cell carcinoma of the head and neck[J]. Laryngoscope, 2000, 110(9):1479-1482.
pmid: 10983946
[3] Soriano E, Faure C, Lantuejoul S, et al. Course and prognosis of basaloid squamous cell carcinoma of the head and neck: a case-control study of 62 patients[J]. Eur J Cancer, 2008, 44(2):244-250.
doi: 10.1016/j.ejca.2007.11.008
[4] Ramqvist T, Näsman A, Franzeén B, et al. Protein expression in tonsillar and base of tongue cancer and in relation to human papillomavirus (HPV) and clinical outcome.[J]. Int J Mol Sci, 2018, 19(4):978.
doi: 10.3390/ijms19040978
[5] Näsman A, Bersani C, Lindquist D, et al. Human papillomavirus and potentially relevant biomarkers in tonsillar and base of tongue squamous cell carcinoma[J]. Anticancer Res, 2017, 37(10):5319-5328.
[6] Xu Y, Zhao H, Tong Y, et al. Comparative analysis of clinicopathological characteristics, survival features, and protein expression between basaloid and squamous cell carcinoma of the esophagus[J]. Int J Gen Med, 2021, 14:3929-3939.
doi: 10.2147/IJGM.S314054
[7] Linton OR, Moore MG, Brigance JS, et al. Prognostic significance of basaloid squamous cell carcinoma in head and neck can-cer[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139(12):1306-1311.
doi: 10.1001/jamaoto.2013.5308
[8] Thariat J, Badoual C, Faure C, et al. Basaloid squamous cell carcinoma of the head and neck: role of HPV and implication in treatment and prognosis[J]. J Clin Pathol, 2010, 63(10):857-866.
doi: 10.1136/jcp.2010.078154 pmid: 20876315
[9] de Sampaio Góes FC, Oliveira DT, Dorta RG, et al. Prognoses of oral basaloid squamous cell carcinomas and squamous cell carcinoma: a comparison[J]. Arch Otolaryngol Head Neck Surg, 2004, 130(1):83-86.
doi: 10.1001/archotol.130.1.83
[10] Yu GY, Gao Y, Peng X, et al. A clinicopathologic study on basaloid squamous cell carcinoma in the oral and maxillofacial region[J]. Int J Oral Maxillofac Surg, 2008, 37(11):1003-1008.
doi: 10.1016/j.ijom.2008.05.019
[11] 代璐岭, 杨秀秀, 赵好为, 等. 牙龈基底细胞样鳞状细胞癌1例[J]. 华西口腔医学杂志, 2020, 38(3):347-350.
[12] Sato F, Bhawal UK, Tojyo I, et al. Differential expression of claudin-4, occludin, SOX2 and proliferating cell nuclear antigen between basaloid squamous cell carcinoma and squamous cell carcinoma[J]. Mol Med Rep, 2019, 20(2):1977-1985.
[13] Schuch LF, Nóbrega KHS, Gomes APN, et al. Basaloid squamous cell carcinoma: a 31-year retrospective study and analysis of 214 cases reported in the literature[J]. Oral Maxillofac Surg, 2020, 24(1):103-108.
doi: 10.1007/s10006-020-00828-9
[14] Lee JH, Kang HJ, Yoo CW, et al. PLAG1, SOX10, and Myb expression in benign and malignant salivary gland neoplasms[J]. J Pathol Transl Med, 2019, 53(1):23-30.
doi: 10.4132/jptm.2018.10.12
[15] Hsieh MS, Lee YH, Chang YL. SOX10-positive salivary gland tumors: a growing list, including mammary analogue secretory carcinoma of the salivary gland, sialoblastoma, low-grade salivary duct carcinoma, basal cell adenoma/adenocarcinoma, and a subgroup of mucoepidermoid carcinoma[J]. Hum Pathol, 2016, 56:134-142.
doi: 10.1016/j.humpath.2016.05.021
[16] Adkins BD, Geromes A, Zhang LY, et al. SOX10 and GATA3 in adenoid cystic carcinoma and polymorphous adenocarcinoma[J]. Head Neck Pathol, 2020, 14(2):406-411.
doi: 10.1007/s12105-019-01046-w pmid: 31222589
[17] Nakaguro M, Tada Y, Faquin WC, et al. Salivary duct carcinoma: updates in histology, cytology, molecular biology, and treatment[J]. Cancer Cytopathol, 2020, 128(10):693-703.
doi: 10.1002/cncy.22288 pmid: 32421944
[18] Boon E, Bel M, van Boxtel W, et al. A clinicopathological study and prognostic factor analysis of 177 salivary duct carcinoma patients from The Netherlands[J]. Int J Cancer, 2018, 143(4):758-766.
doi: 10.1002/ijc.31353
[19] Santana T, Pavel A, Martinek P, et al. Biomarker immunoprofile and molecular characteristics in salivary duct carcinoma: clinicopathological and prognostic implications[J]. Hum Pathol, 2019, 93:37-47.
doi: 10.1016/j.humpath.2019.08.009
[20] Villada G, Kryvenko ON, Campuzano-Zuluaga G, et al. A limited immunohistochemical panel to distinguish basal cell carcinoma of cutaneous origin from basaloid squamous cell carcinoma of the head and neck[J]. Appl Immunohistochem Mol Morphol, 2018, 26(2):126-131.
doi: 10.1097/PAI.0000000000000394
[21] Mendelsohn AH, Lai CK, Shintaku IP, et al. Histopathologic findings of HPV and p16 positive HNSCC[J]. Laryngoscope, 2010, 120(9):1788-1794.
doi: 10.1002/lary.21044
[22] Begum S, Westra WH. Basaloid squamous cell carcinoma of the head and neck is a mixed variant that can be further resolved by HPV status[J]. Am J Surg Pathol, 2008, 32(7):1044-1050.
doi: 10.1097/PAS.0b013e31816380ec
[23] Lai K, Killingsworth M, Matthews S, et al. Differences in survival outcome between oropharyngeal and oral cavity squamous cell carcinoma in relation to HPV status[J]. J Oral Pathol Med, 2017, 46(8):574-582.
doi: 10.1111/jop.2017.46.issue-8
[24] Duncan LD, Winkler M, Carlson ER, et al. P16 immunohistochemistry can be used to detect human papillomavirus in oral cavity squamous cell carcinoma[J]. J Oral Maxillofac Surg, 2013, 71(8):1367-1375.
doi: 10.1016/j.joms.2013.02.019
[1] SU Jun-qi,SONG Yang,XIE Shang. Analysis of etiological characteristics and establishment of prediction model of postoperative infections in patients undergoing oral squamous cell carcinoma surgery with free flap reconstruction [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 68-76.
[2] Lei-zhen SU,Jie CHEN,Xian LI,Ping JI. Effects of salinomycin on proliferation and apoptosis of oral squamous cell carcinoma [J]. Journal of Peking University (Health Sciences), 2020, 52(5): 902-906.
[3] Chuan-si-bo TAO,Fan DONG,Dian-can WANG,Chuan-bin GUO. Diagnostic test for detection of cervical lymph node metastasis from oral squamous cell carcinoma via infrared thermal imaging [J]. Journal of Peking University(Health Sciences), 2019, 51(5): 959-963.
[4] Yang LIU,Yan GAO,Xue-jie CHEN,Hong HUA. DNA cytometry of exfoliated cells in the diagnosis of oral potential malignant disorders [J]. Journal of Peking University(Health Sciences), 2019, 51(1): 16-20.
[5] Chun-feng ZHANG,Yun LIU,Min LU,Xiao-juan DU. Expression of hUTP14a in non-small cell lung cancer [J]. Journal of Peking University(Health Sciences), 2019, 51(1): 145-150.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 158 -161 .
[2] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 323 -328 .
[3] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 329 -332 .
[4] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 343 -345 .
[5] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 365 -368 .
[6] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 423 -425 .
[7] . [J]. Journal of Peking University(Health Sciences), 2007, 39(4): 445 .
[8] . [J]. Journal of Peking University(Health Sciences), 2007, 39(5): 453 -457 .
[9] . [J]. Journal of Peking University(Health Sciences), 2001, 33(3): 258 -262 .
[10] . [J]. Journal of Peking University(Health Sciences), 2001, 33(3): 263 -265 .
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd