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== Variants == |
== Variants == |
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Currently, four variants (papillary, small cell, clear cell, and basaloid) of squamous cell carcinoma of the lung are recognized. Of these variants, there is some evidence that the basaloid<ref name='WangWang'>{{cite journal |pmid=21269455 |year=2011 |last1=Wang |first1=LC |last2=Wang |first2=L |last3=Kwauk |first3=S |last4=Woo |first4=JA |last5=Wu |first5=LQ |last6=Zhu |first6=H |last7=Zhan |first7=LZ |last8=Sun |first8=NL |last9=Zhang |first9=L |title=Analysis on the clinical features of 22 basaloid squamous cell carcinoma of the lung |volume=6 |page=10 |doi=10.1186/1749-8090-6-10 |pmc=3037842 |journal=[[Journal of Cardiothoracic Surgery]] |
Currently, four variants (papillary, small cell, clear cell, and basaloid) of squamous cell carcinoma of the lung are recognized. Of these variants, there is some evidence that the basaloid<ref name='WangWang'>{{cite journal |pmid=21269455 |year=2011 |last1=Wang |first1=LC |last2=Wang |first2=L |last3=Kwauk |first3=S |last4=Woo |first4=JA |last5=Wu |first5=LQ |last6=Zhu |first6=H |last7=Zhan |first7=LZ |last8=Sun |first8=NL |last9=Zhang |first9=L |title=Analysis on the clinical features of 22 basaloid squamous cell carcinoma of the lung |volume=6 |page=10 |doi=10.1186/1749-8090-6-10 |pmc=3037842 |journal=[[Journal of Cardiothoracic Surgery]] }}</ref> and poorly differentiated small-cell variants <ref name='who2004'>{{cite book |title=Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart |editor1-last=Travis |editor1-first=William D |editor2-last=Brambilla |editor2-first=Elisabeth |editor3-last=Muller-Hermelink |editor3-first=H Konrad |editor4-last=Harris |editor4-first=Curtis C |publisher=IARC Press |location=Lyon |year=2004 |series=World Health Organization Classification of Tumours |isbn=92-832-2418-3 |url=http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |accessdate=27 March 2010}}</ref> may have worse prognoses than "conventional" squamous cell carcinomas. The papillary variant occurs more frequently as a primarily superficial, endobronchial lesion, with a modestly better prognosis<ref name='Dulmet-Brender'>{{cite journal |author=Dulmet-Brender E, Jaubert F, Huchon G |title=Exophytic endobronchial epidermoid carcinoma |journal=Cancer |volume=57 |issue=7 |pages=1358–64 |date=April 1986 |pmid=3948117 |doi=10.1002/1097-0142(19860401)57:7<1358::AID-CNCR2820570719>3.0.CO;2-B }}</ref> Very little data is currently available on the clear cell variant of squamous cell carcinoma, and no consensus has been reached on the prognostic implications of clear cell changes in lung cancer.<ref name='Kitadazawa'>{{cite journal |author=Kitada M, Ozawa K, Sato K, Hayashi S, Miyokawa N, Sasajima T |title=Clear cell carcinoma of the lung |journal=Gen Thorac Cardiovasc Surg |volume=58 |issue=2 |pages=87–90 |date=February 2010 |pmid=20155345 |doi=10.1007/s11748-009-0471-8 }}, which are usually due to increased levels of intracellular glycogen (or, rarely, biotin).</ref><ref name='GarzonLai'>{{cite journal |pmid=16214540 |year=2005 |last1=Garzon |first1=JC |last2=Lai |first2=FM |last3=Mok |first3=TS |last4=Manlulu |first4=AV |last5=Ng |first5=CS |last6=Lee |first6=TW |last7=Yim |first7=AP |title=Clear cell carcinoma of the lung revisited |volume=130 |issue=4 |pages=1198–9 |doi=10.1016/j.jtcvs.2005.04.030 |journal=The Journal of thoracic and cardiovascular surgery}}</ref> |
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== RNA expression profiles == |
== RNA expression profiles == |
Revision as of 15:27, 3 January 2015
Squamous cell carcinoma (SCC) of the lung is more common in men than in women. It is closely correlated with a history of tobacco smoking, more so than most other types of lung cancer. According to the Nurses' Health Study, the relative risk of SCC is approximately 5.5, both among those with a previous duration of smoking of 1 to 20 years, and those with 20 to 30 years, compared to never-smokers.[1] The relative risk increases to approximately 16 with a previous smoking duration of 30 to 40 years, and approximately 22 with more than 40 years.[1]
Description
It most often arises centrally in larger bronchi, and while it often metastasizes to locoregional lymph nodes (particularly the hilar nodes) early in its course, it generally disseminates outside the thorax somewhat later than other major types of lung cancer. Large tumors may undergo central necrosis, resulting in cavitation. A squamous cell carcinoma is often preceded for years by squamous cell metaplasia or dysplasia in the respiratory epithelium of the bronchi, which later transforms to carcinoma in situ.
In carcinoma in situ, atypical cells may be identified by cytologic smear test of sputum, bronchoalveolar lavage or samples from endobronchial brushings. However, squamous-cell carcinoma in situ is asymptomatic and undetectable on X-ray radiographs.
Eventually, it becomes symptomatic, usually when the tumor mass begins to obstruct the lumen of a major bronchus, often producing distal atelectasis and infection. Simultaneously, the lesion invades into the surrounding pulmonary substance. On histopathology, these tumors range from well differentiated, showing keratin pearls and cell junctions, to anaplastic, with only minimal residual squamous cell features.[2]
Variants
Currently, four variants (papillary, small cell, clear cell, and basaloid) of squamous cell carcinoma of the lung are recognized. Of these variants, there is some evidence that the basaloid[3] and poorly differentiated small-cell variants [4] may have worse prognoses than "conventional" squamous cell carcinomas. The papillary variant occurs more frequently as a primarily superficial, endobronchial lesion, with a modestly better prognosis[5] Very little data is currently available on the clear cell variant of squamous cell carcinoma, and no consensus has been reached on the prognostic implications of clear cell changes in lung cancer.[6][7]
RNA expression profiles
Recently, four mRNA expression subtypes (primitive, basal, secretory, and classical) were identified and validated within squamous cell carcinoma. The primitive subtype correlates with worse patient survival. These subtypes, defined by intrinsic expression differences, provide a possible foundation for improved patient prognosis and research into individualized therapies.[8]
References
- ^ a b Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1136/tc.2007.022582, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with
|doi=10.1136/tc.2007.022582
instead. - ^ Entire section, if not else specified, is taken from Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. "Ch. 13, box on morphology of squamous cell carcinoma". Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. ISBN 1-4160-2973-7.
{{cite book}}
: CS1 maint: multiple names: authors list (link) - ^ Wang, LC; Wang, L; Kwauk, S; Woo, JA; Wu, LQ; Zhu, H; Zhan, LZ; Sun, NL; Zhang, L (2011). "Analysis on the clinical features of 22 basaloid squamous cell carcinoma of the lung". Journal of Cardiothoracic Surgery. 6: 10. doi:10.1186/1749-8090-6-10. PMC 3037842. PMID 21269455.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Travis, William D; Brambilla, Elisabeth; Muller-Hermelink, H Konrad; Harris, Curtis C, eds. (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart (PDF). World Health Organization Classification of Tumours. Lyon: IARC Press. ISBN 92-832-2418-3. Retrieved 27 March 2010.
- ^ Dulmet-Brender E, Jaubert F, Huchon G (April 1986). "Exophytic endobronchial epidermoid carcinoma". Cancer. 57 (7): 1358–64. doi:10.1002/1097-0142(19860401)57:7<1358::AID-CNCR2820570719>3.0.CO;2-B. PMID 3948117.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Kitada M, Ozawa K, Sato K, Hayashi S, Miyokawa N, Sasajima T (February 2010). "Clear cell carcinoma of the lung". Gen Thorac Cardiovasc Surg. 58 (2): 87–90. doi:10.1007/s11748-009-0471-8. PMID 20155345.
{{cite journal}}
: CS1 maint: multiple names: authors list (link), which are usually due to increased levels of intracellular glycogen (or, rarely, biotin). - ^ Garzon, JC; Lai, FM; Mok, TS; Manlulu, AV; Ng, CS; Lee, TW; Yim, AP (2005). "Clear cell carcinoma of the lung revisited". The Journal of thoracic and cardiovascular surgery. 130 (4): 1198–9. doi:10.1016/j.jtcvs.2005.04.030. PMID 16214540.
- ^ Wilkerson, MD; Yin, X; Hoadley, KA; Liu, Y; Hayward, MC; Cabanski, CR; Muldrew, K; Miller, CR; Randell, SH; Socinski, M. A.; Parsons, A. M.; Funkhouser, W. K.; Lee, C. B.; Roberts, P. J.; Thorne, L.; Bernard, P. S.; Perou, C. M.; Hayes, D. N. (2010). "Lung squamous cell carcinoma mRNA expression subtypes are reproducible, clinically important, and correspond to normal cell types". Clinical cancer research : an official journal of the American Association for Cancer Research. 16 (19): 4864–75. doi:10.1158/1078-0432.CCR-10-0199. PMC 2953768. PMID 20643781.