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Pulmonary squamous cell carcinoma following head and neck squamous cell carcinoma: Metastasis or second primary?

机译：头颈部鳞状细胞癌之后的肺鳞状细胞癌：转移还是第二原发性？

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Purpose: To distinguish a metastasis from a second primary tumor in patients with a history of head and neck squamous cell carcinoma and subsequent pulmonary squamous cell carcinoma. Experimental Design: For 44 patients with a primary squamous cell carcinoma of the head and neck followed by a squamous cell carcinoma of the lung, clinical data, histology, and analysis of loss of heterozygosity (LOH) were used to differentiate metastases from second primary tumors. Results: Clinical evaluation suggested 38 patients with metastases and 6 with second primaries. We developed a novel interpretation strategy based on biological insight and on our observation that multiple LOH on different chromosome arms are not independent. LOH analysis indicated metastatic disease in 19 cases and second primary squamous cell carcinoma in 24 cases. In one case, LOH analysis was inconclusive. For 25 patients, LOH supported the clinical scoring, and in 18 cases, it did not. These 18 discordant cases were all considered to be second primary tumors by LOH analysis. Conclusions: A considerable number of squamous cell lung lesions (50% in this study), clinically interpreted as metastases, are suggested to be second primaries by LOH analysis. For these patients, a surgical approach with curative intent may be justified
机译：目的：区分具有头颈部鳞状细胞癌和随后的肺鳞状细胞癌病史的患者与第二原发肿瘤的转移。实验设计：对于44例头颈部原发性鳞状细胞癌，然后是肺鳞状细胞癌的患者，使用临床数据，组织学和杂合性丧失（LOH）分析来区分转移与第二原发性肿瘤。结果：临床评估提示38例转移灶患者和6例第二原发灶患者。我们基于生物学洞察力和观察到的不同染色体臂上的多个LOH不是独立的，开发了一种新颖的解释策略。 LOH分析显示有转移性疾病19例，第二原发性鳞状细胞癌24例。在一个案例中，LOH分析没有定论。 LOH支持25例患者的临床评分，而18例患者则不支持。通过LOH分析，这18个不一致的病例都被认为是第二原发肿瘤。结论：根据LOH分析，大量鳞状细胞肺病变（本研究中为50％）被临床认为是转移灶，被认为是第二原发灶。对于这些患者，可能需要采用具有治愈意图的手术方法

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