Squamous cell carcinoma lung prognosis

Prognosis for squamous cell carcinoma.

Squamous cell carcinoma (syn. epidermoid carcinoma), along with adenocarcinoma - one of the most common malignant epithelial tumors of the lung. In 2 / s patients squamous cell carcinoma refers to the central form of lung cancer and affects large bronchi, trachea less. Over 85% of these tumors are localized in the segmental bronchi and subsegmentrnyh. The remaining part is the peripheral form of cancer. Most patients suffer from long-term habit of smoking. In 18% of them the human papilloma virus (HPV), and 10% - foci of squamous metaplasia of the bronchus, in particular changing the type of warts. Diameter node squamous cancer varies from a few millimeters up to 20-30 cm tumor may replace whole lung. The central epidermoid carcinoma, even with a small amount of assembly is prone to ulceration.

Often the tumor site is dry and scaly surface grayish-white or yellowish in color, the cut in the third, cases - areas of necrosis and hemorrhage. By the tumor can join a secondary infection. Due to severe stromal desmoplasia some tumor sites have a dense texture and a whitish color. In the bronchial mucosa areas near the tumor can be detected in situ carcinoma and dysplasia lining varying degrees. When exophytic squamous cell carcinoma of early symptoms of airway obstruction. Therefore, at the time of diagnosis of this cancer in the middle reaches this size, like other forms of bronchopulmonary cancer. Exophytic endobronchial cancer may or may not be accompanied by invasion into the surrounding lung parenchyma. This parenchyma distal to the tumor revealed atelectasis, mukostaz, organization pockets, secondary infection and abscess formation. Level 5 Letnyany survival in patients with squamous cell bronchopulmonary cancer is about 15%.

Under the microscope, the degree of histological differentiation of squamous cell carcinoma may be divided into high, moderate and Poorly types. Signs of keratinization (cancer "pearls") and spiny epithelial intercellular bridges are best expressed in well-differentiated carcinoma. Occasionally found this type of squamous cell carcinoma, which is extremely vysokodiffereniirovannym, and cytological features of malignancy can not catch him. This type of cancer malignancy is recognized only based on the surrounding tissue invasive squamous cell lung parenchyma usually grows layers surrounded by stroma, which may be fibrous and have signs of acute or chronic inflammation. Poorly cancer is not generally prone to keratinization. Some forms nizkodiffereniirovannogo squamous cell cancer characterized by the lack of recovery of the parenchyma, loose growth of malignant epithelial cells, extensive inflammatory infiltration. It may be difficult to distinguish from inflammatory types of malignant histiocytoma or Hodgkin's disease.

Cellular and nuclear polymorphism, well-marked and accompanied by the advent of highly atypical giant cells. Cancer layers grow in many cases of pulmonary alveoli in the cavity the tissue surrounding the tumor site. Malignant epithelial cells can replace the alveolar cells and form a cancerous parenchyma small acini. Approximately half of the cases of squamous cell carcinoma cells, some contain alcian-positive slimy stuff. The parenchyma of the cancer in the majority of patients showing positive reactions to cytokeratins, S100-protein, Leu-Ml, epithelial membrane antigen and carcinoembryonic antigen. Sometimes its cells are mucins and neurosecretory granules. Like other forms of cancer, squamous cell carcinoma may exhibit morphological diversity and form bazaloidnye or spindle-shaped cells, giant tumor elements, osteoclastic giant cells, an optically empty cytoplasm. Some tumors have onkotsitoidnye features of differentiation, accompanied by an increase in the number of mitochondria in the cytoplasm. Squamous cell carcinoma should be differentiated from other types of bronchopulmonary cancer and metastatic squamous cell tumors at other sites.

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