Skip to main content
Erschienen in: Surgery Today 3/2015

01.03.2015 | Original Article

Clinicopathological features and surgical outcomes of adenosquamous carcinoma of the pancreas: a retrospective analysis of patients with resectable stage tumors

verfasst von: Hirotake Komatsu, Shinichi Egawa, Fuyuhiko Motoi, Takanori Morikawa, Naoaki Sakata, Takeshi Naitoh, Yu Katayose, Kazuyuki Ishida, Michiaki Unno

Erschienen in: Surgery Today | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Adenosquamous carcinoma of the pancreas is a rare subtype of pancreatic cancer. We herein describe the clinicopathological features of surgically resected cases of adenosquamous carcinoma of the pancreas.

Methods

From 2001 to 2011, 132 patients underwent R0 resection for Stage IIA or IIB pancreatic cancer. The survival rate, pathological features and recurrence status were reviewed.

Results

Out of 132 patients, 121 patients had tubular adenocarcinoma, and only seven had adenosquamous carcinoma (ASC). The incidence of ASC increased with the tumor size. The overall survival and disease-free survival periods of the patients with ASC were significantly shorter than those of patients with tubular adenocarcinoma (p = 0.0153 and p = 0.0045). The histological findings revealed more marked venous invasion in ASC compared to tubular adenocarcinoma (G1, G2 and G3). The proportion of v3 cases, which denotes the most severe venous invasion, was 31.3 % in G1, 47.3 % in G2, 60.0 % in G3 and 71.4 % in ASC cases, respectively. Other factors, including lymphatic and nerve invasion, were not correlated with the histological subtypes. The incidence of ASC was 11.1 % in the tumors more than 6 cm in diameter, and 0 % in those less than 2 cm in diameter.

Conclusions

We revealed that adenosquamous carcinoma of the pancreas is associated with a poor outcome, and also clarified its clinicopathological features.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Hruban RH, Pitman MB, Klimstra DS. Adenosquamous carcinoma. In: Tumors of the pancreas (Afip Atlas of Tumor Pathology; 4th Series Fascicle 6). Washington, DC: American Registry of Pathology; 2007. p. 165–8. Hruban RH, Pitman MB, Klimstra DS. Adenosquamous carcinoma. In: Tumors of the pancreas (Afip Atlas of Tumor Pathology; 4th Series Fascicle 6). Washington, DC: American Registry of Pathology; 2007. p. 165–8.
2.
Zurück zum Zitat Fukushima N, Hruban RH, Kato Y, Klimstra DS, Klöppel G, Shimizu M, et al. Ductal adenocarcinoma variants and mixed neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, editors. WHO classification of tumors of the digestive system. Lyon: International Agency for Research on Cancer (IARC); 2010. p. 292. Fukushima N, Hruban RH, Kato Y, Klimstra DS, Klöppel G, Shimizu M, et al. Ductal adenocarcinoma variants and mixed neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, editors. WHO classification of tumors of the digestive system. Lyon: International Agency for Research on Cancer (IARC); 2010. p. 292.
3.
Zurück zum Zitat Japan Pancreas Society. Classification of pancreatic carcinoma. Tokyo: Kanehara and Co.; 2003. p. 29–30. Japan Pancreas Society. Classification of pancreatic carcinoma. Tokyo: Kanehara and Co.; 2003. p. 29–30.
4.
Zurück zum Zitat Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.CrossRefPubMed Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.CrossRefPubMed
5.
Zurück zum Zitat Hsu JT, Chen HM, Wu RC, Yeh CN, Yeh TS, Hwang TL, et al. Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma. World J Surg Oncol. 2008;6:95.CrossRefPubMedCentralPubMed Hsu JT, Chen HM, Wu RC, Yeh CN, Yeh TS, Hwang TL, et al. Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma. World J Surg Oncol. 2008;6:95.CrossRefPubMedCentralPubMed
6.
Zurück zum Zitat Regi P, Butturini G, Malleo G, Pedica F, D’Onofrio M, Bassi C. Clinicopathological features of adenosquamous pancreatic cancer. Langenbecks Arch Surg. 2011;396:217–22.CrossRefPubMed Regi P, Butturini G, Malleo G, Pedica F, D’Onofrio M, Bassi C. Clinicopathological features of adenosquamous pancreatic cancer. Langenbecks Arch Surg. 2011;396:217–22.CrossRefPubMed
7.
Zurück zum Zitat Cihak RW, Kawashima T, Steer A. Adenoacanthoma (adenosquamous carcinoma) of the pancreas. Cancer. 1972;29:1133–40.CrossRefPubMed Cihak RW, Kawashima T, Steer A. Adenoacanthoma (adenosquamous carcinoma) of the pancreas. Cancer. 1972;29:1133–40.CrossRefPubMed
8.
Zurück zum Zitat Katz MH, Taylor TH, Al-Refaie WB, Hanna MH, Imagawa DK, Anton-Culver H, et al. Adenosquamous versus adenocarcinoma of the pancreas: a population-based outcomes analysis. J Gastrointest Surg. 2011;15:165–74.CrossRefPubMedCentralPubMed Katz MH, Taylor TH, Al-Refaie WB, Hanna MH, Imagawa DK, Anton-Culver H, et al. Adenosquamous versus adenocarcinoma of the pancreas: a population-based outcomes analysis. J Gastrointest Surg. 2011;15:165–74.CrossRefPubMedCentralPubMed
9.
Zurück zum Zitat Smoot RL, Zhang L, Sebo TJ, Que FG. Adenosquamous carcinoma of the pancreas: a single-institution experience comparing resection and palliative care. J Am Coll Surg. 2008;207:368–70.CrossRefPubMed Smoot RL, Zhang L, Sebo TJ, Que FG. Adenosquamous carcinoma of the pancreas: a single-institution experience comparing resection and palliative care. J Am Coll Surg. 2008;207:368–70.CrossRefPubMed
11.
Zurück zum Zitat Bastide K, Ugolin N, Levalois C, Bernaudin JF, Chevillard S. Are adenosquamous lung carcinomas a simple mix of adenocarcinomas and squamous cell carcinomas, or more complex at the molecular level? Lung Cancer. 2010;68:1–9.CrossRefPubMed Bastide K, Ugolin N, Levalois C, Bernaudin JF, Chevillard S. Are adenosquamous lung carcinomas a simple mix of adenocarcinomas and squamous cell carcinomas, or more complex at the molecular level? Lung Cancer. 2010;68:1–9.CrossRefPubMed
12.
Zurück zum Zitat Hofmann HS, Knolle J, Neef H. The adenosquamous lung carcinoma: clinical and pathological characteristics. J Cardiovasc Surg (Torino). 1994;35:543–7. Hofmann HS, Knolle J, Neef H. The adenosquamous lung carcinoma: clinical and pathological characteristics. J Cardiovasc Surg (Torino). 1994;35:543–7.
13.
Zurück zum Zitat Cagir B, Nagy MW, Topham A, Rakinic J, Fry RD. Adenosquamous carcinoma of the colon, rectum, and anus: epidemiology, distribution, and survival characteristics. Dis Colon Rectum. 1999;42:258–63.CrossRefPubMed Cagir B, Nagy MW, Topham A, Rakinic J, Fry RD. Adenosquamous carcinoma of the colon, rectum, and anus: epidemiology, distribution, and survival characteristics. Dis Colon Rectum. 1999;42:258–63.CrossRefPubMed
14.
Zurück zum Zitat Castellsague X, Diaz M, de Sanjose S, Munoz N, Herrero R, Franceschi S, et al. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst. 2006;98:303–15.CrossRefPubMed Castellsague X, Diaz M, de Sanjose S, Munoz N, Herrero R, Franceschi S, et al. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst. 2006;98:303–15.CrossRefPubMed
15.
Zurück zum Zitat Lee WA, Woo DK, Kim YI, Kim WH. p53, p16 and RB expression in adenosquamous and squamous cell carcinomas of the stomach. Pathol Res Pract. 1999;195:747–52.CrossRefPubMed Lee WA, Woo DK, Kim YI, Kim WH. p53, p16 and RB expression in adenosquamous and squamous cell carcinomas of the stomach. Pathol Res Pract. 1999;195:747–52.CrossRefPubMed
16.
Zurück zum Zitat Naunheim KS, Taylor JR, Skosey C, Hoffman PC, Ferguson MK, Golomb HM, et al. Adenosquamous lung carcinoma: clinical characteristics, treatment, and prognosis. Ann Thorac Surg. 1987;44:462–6.CrossRefPubMed Naunheim KS, Taylor JR, Skosey C, Hoffman PC, Ferguson MK, Golomb HM, et al. Adenosquamous lung carcinoma: clinical characteristics, treatment, and prognosis. Ann Thorac Surg. 1987;44:462–6.CrossRefPubMed
17.
Zurück zum Zitat Takamori S, Noguchi M, Morinaga S, Goya T, Tsugane S, Kakegawa T, et al. Clinicopathologic characteristics of adenosquamous carcinoma of the lung. Cancer. 1991;67:649–54.CrossRefPubMed Takamori S, Noguchi M, Morinaga S, Goya T, Tsugane S, Kakegawa T, et al. Clinicopathologic characteristics of adenosquamous carcinoma of the lung. Cancer. 1991;67:649–54.CrossRefPubMed
18.
Zurück zum Zitat Oettle H, Post S, Neuhaus P, Gellert K, Langrehr J, Ridwelski K, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007;297:267–77.CrossRefPubMed Oettle H, Post S, Neuhaus P, Gellert K, Langrehr J, Ridwelski K, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007;297:267–77.CrossRefPubMed
19.
Zurück zum Zitat Sternberg A, Amar M, Alfici R, Groisman G. Conclusions from a study of venous invasion in stage IV colorectal adenocarcinoma. J Clin Pathol. 2002;55:17–21.CrossRefPubMedCentralPubMed Sternberg A, Amar M, Alfici R, Groisman G. Conclusions from a study of venous invasion in stage IV colorectal adenocarcinoma. J Clin Pathol. 2002;55:17–21.CrossRefPubMedCentralPubMed
21.
Zurück zum Zitat Pancreas (ICD-O C25). In: Sobin LH, Gospodarowic MKz, Wittekind Ch, editors. TNM classification of malignant tumours. West Sussex: Blackwell Publishing Ltd; 2009. p. 132–5. Pancreas (ICD-O C25). In: Sobin LH, Gospodarowic MKz, Wittekind Ch, editors. TNM classification of malignant tumours. West Sussex: Blackwell Publishing Ltd; 2009. p. 132–5.
22.
Zurück zum Zitat Kardon DE, Thompson LD, Przygodzki RM, Heffess CS. Adenosquamous carcinoma of the pancreas: a clinicopathologic series of 25 cases. Mod Pathol. 2001;14:443–51.CrossRefPubMed Kardon DE, Thompson LD, Przygodzki RM, Heffess CS. Adenosquamous carcinoma of the pancreas: a clinicopathologic series of 25 cases. Mod Pathol. 2001;14:443–51.CrossRefPubMed
23.
Zurück zum Zitat Madura JA, Jarman BT, Doherty MG, Yum MN, Howard TJ. Adenosquamous carcinoma of the pancreas. Arch Surg. 1999;134:599–603.CrossRefPubMed Madura JA, Jarman BT, Doherty MG, Yum MN, Howard TJ. Adenosquamous carcinoma of the pancreas. Arch Surg. 1999;134:599–603.CrossRefPubMed
24.
Zurück zum Zitat Rahemtullah A, Misdraji J, Pitman MB. Adenosquamous carcinoma of the pancreas: cytologic features in 14 cases. Cancer. 2003;99:372–8.CrossRefPubMed Rahemtullah A, Misdraji J, Pitman MB. Adenosquamous carcinoma of the pancreas: cytologic features in 14 cases. Cancer. 2003;99:372–8.CrossRefPubMed
25.
Zurück zum Zitat Mrstik C, Salamon J, Weber R, Stogermayer F. Microscopic venous infiltration as predictor of relapse in renal cell carcinoma. J Urol. 1992;148:271–4.PubMed Mrstik C, Salamon J, Weber R, Stogermayer F. Microscopic venous infiltration as predictor of relapse in renal cell carcinoma. J Urol. 1992;148:271–4.PubMed
26.
Zurück zum Zitat Yi X, Luk JM, Lee NP, Peng J, Leng X, Guan XY, et al. Association of mortalin (HSPA9) with liver cancer metastasis and prediction for early tumor recurrence. Mol Cell Proteomics. 2008;7:315–25.CrossRefPubMed Yi X, Luk JM, Lee NP, Peng J, Leng X, Guan XY, et al. Association of mortalin (HSPA9) with liver cancer metastasis and prediction for early tumor recurrence. Mol Cell Proteomics. 2008;7:315–25.CrossRefPubMed
27.
Zurück zum Zitat Motojima K, Tomioka T, Kohara N, Tsunoda T, Kanematsu T. Immunohistochemical characteristics of adenosquamous carcinoma of the pancreas. J Surg Oncol. 1992;49:58–62.CrossRefPubMed Motojima K, Tomioka T, Kohara N, Tsunoda T, Kanematsu T. Immunohistochemical characteristics of adenosquamous carcinoma of the pancreas. J Surg Oncol. 1992;49:58–62.CrossRefPubMed
28.
Zurück zum Zitat Jamieson JD, Ingber DE, Muresan V, Hull BE, Sarras MP Jr, Maylie-Pfenninger MF, et al. Cell surface properties of normal, differentiating, and neoplastic pancreatic acinar cells. Cancer. 1981;47:1516–27.CrossRefPubMed Jamieson JD, Ingber DE, Muresan V, Hull BE, Sarras MP Jr, Maylie-Pfenninger MF, et al. Cell surface properties of normal, differentiating, and neoplastic pancreatic acinar cells. Cancer. 1981;47:1516–27.CrossRefPubMed
29.
Zurück zum Zitat Brody JR, Costantino CL, Potoczek M, Cozzitorto J, McCue P, Yeo CJ, et al. Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma. Mod Pathol. 2009;22:651–9.CrossRefPubMed Brody JR, Costantino CL, Potoczek M, Cozzitorto J, McCue P, Yeo CJ, et al. Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma. Mod Pathol. 2009;22:651–9.CrossRefPubMed
30.
Zurück zum Zitat Kanazawa H, Ebina M, Ino-Oka N, Shimizukawa M, Takahashi T, Fujimura S, et al. Transition from squamous cell carcinoma to adenocarcinoma in adenosquamous carcinoma of the lung. Am J Pathol. 2000;156:1289–98.CrossRefPubMedCentralPubMed Kanazawa H, Ebina M, Ino-Oka N, Shimizukawa M, Takahashi T, Fujimura S, et al. Transition from squamous cell carcinoma to adenocarcinoma in adenosquamous carcinoma of the lung. Am J Pathol. 2000;156:1289–98.CrossRefPubMedCentralPubMed
31.
Zurück zum Zitat Niho S, Yokose T, Kodama T, Nishiwaki Y, Mukai K. Clonal analysis of adenosquamous carcinoma of the lung. Jpn J Cancer Res. 1999;90:1244–7.CrossRefPubMed Niho S, Yokose T, Kodama T, Nishiwaki Y, Mukai K. Clonal analysis of adenosquamous carcinoma of the lung. Jpn J Cancer Res. 1999;90:1244–7.CrossRefPubMed
32.
Zurück zum Zitat Toyooka S, Yatabe Y, Tokumo M, Ichimura K, Asano H, Tomii K, et al. Mutations of epidermal growth factor receptor and K-ras genes in adenosquamous carcinoma of the lung. Int J Cancer. 2006;118:1588–90.CrossRefPubMed Toyooka S, Yatabe Y, Tokumo M, Ichimura K, Asano H, Tomii K, et al. Mutations of epidermal growth factor receptor and K-ras genes in adenosquamous carcinoma of the lung. Int J Cancer. 2006;118:1588–90.CrossRefPubMed
33.
Zurück zum Zitat Woo DK, Lee WA, Kim YI, Kim WH. Microsatellite instability and alteration of E2F-4 gene in adenosquamous and squamous cell carcinomas of the stomach. Pathol Int. 2000;50:690–5.CrossRefPubMed Woo DK, Lee WA, Kim YI, Kim WH. Microsatellite instability and alteration of E2F-4 gene in adenosquamous and squamous cell carcinomas of the stomach. Pathol Int. 2000;50:690–5.CrossRefPubMed
34.
Zurück zum Zitat Miyoshi K, Shillingford JM, Le Provost F, Gounari F, Bronson R, von Boehmer H, et al. Activation of beta -catenin signaling in differentiated mammary secretory cells induces transdifferentiation into epidermis and squamous metaplasias. Proc Natl Acad Sci USA. 2002;99:219–24.CrossRefPubMedCentralPubMed Miyoshi K, Shillingford JM, Le Provost F, Gounari F, Bronson R, von Boehmer H, et al. Activation of beta -catenin signaling in differentiated mammary secretory cells induces transdifferentiation into epidermis and squamous metaplasias. Proc Natl Acad Sci USA. 2002;99:219–24.CrossRefPubMedCentralPubMed
35.
Zurück zum Zitat Gallego MI, Bierie B, Hennighausen L. Targeted expression of HGF/SF in mouse mammary epithelium leads to metastatic adenosquamous carcinomas through the activation of multiple signal transduction pathways. Oncogene. 2003;22:8498–508.CrossRefPubMed Gallego MI, Bierie B, Hennighausen L. Targeted expression of HGF/SF in mouse mammary epithelium leads to metastatic adenosquamous carcinomas through the activation of multiple signal transduction pathways. Oncogene. 2003;22:8498–508.CrossRefPubMed
36.
Zurück zum Zitat Monga SP, Mars WM, Pediaditakis P, Bell A, Mule K, Bowen WC, et al. Hepatocyte growth factor induces Wnt-independent nuclear translocation of beta-catenin after Met-beta-catenin dissociation in hepatocytes. Cancer Res. 2002;62:2064–71.PubMed Monga SP, Mars WM, Pediaditakis P, Bell A, Mule K, Bowen WC, et al. Hepatocyte growth factor induces Wnt-independent nuclear translocation of beta-catenin after Met-beta-catenin dissociation in hepatocytes. Cancer Res. 2002;62:2064–71.PubMed
Metadaten
Titel
Clinicopathological features and surgical outcomes of adenosquamous carcinoma of the pancreas: a retrospective analysis of patients with resectable stage tumors
verfasst von
Hirotake Komatsu
Shinichi Egawa
Fuyuhiko Motoi
Takanori Morikawa
Naoaki Sakata
Takeshi Naitoh
Yu Katayose
Kazuyuki Ishida
Michiaki Unno
Publikationsdatum
01.03.2015
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 3/2015
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-0934-0

Weitere Artikel der Ausgabe 3/2015

Surgery Today 3/2015 Zur Ausgabe

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Dihydropyridin-Kalziumantagonisten können auf die Nieren gehen

30.04.2024 Hypertonie Nachrichten

Im Vergleich zu anderen Blutdrucksenkern sind Kalziumantagonisten vom Diyhdropyridin-Typ mit einem erhöhten Risiko für eine Mikroalbuminurie und in Abwesenheit eines RAS-Blockers auch für ein terminales Nierenversagen verbunden.

Frauen bekommen seltener eine intensive Statintherapie

30.04.2024 Statine Nachrichten

Frauen in den Niederlanden erhalten bei vergleichbarem kardiovaskulärem Risiko seltener eine intensive Statintherapie als Männer. Ihre LDL-Zielwerte erreichen sie aber fast ähnlich oft.

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.