PDF(Pubmed)
Abstract：
Sinonasal (SN) malignancies are rare. Within SN adenocarcinomas, the most frequent are intestinal-type adenocarcinomas (ITACs). ITAC has been associated with wood and leather dust occupational exposure and TP53 mutations. Not much information is available regarding its characterization and treatment. The aim of this study is to characterize the clinicopathologic and prognostic factors of patients with sinonasal adenocarcinomas (SNACs) treated in our tertiary-level hospital. A retrospective, consecutive study including SNAC patients diagnosed between 2004-2023 was conducted. Clinicopathological data was collected, and p53 status was assessed in the tumor specimens. The association between p53 status and clinicopathological variables, as well as their impact on survival, was evaluated. In total, 35 were included, most of them having ITAC (91.4%) with papillary subtype (37.5%); the majority were subjected to occupational risk exposure (82.9%). Overexpression of p53 was identified in 48.6% of the tumors. Papillary and colonic subtypes were associated with higher median progression-free survival (mPFS) than mucinous and solid subtypes (mPFS 37 months, 95% CI, 20.0-54.0, vs. 9 months, 95% CI, 7.15-10.85, p=0.01); the former was also associated with higher median overall survival (mOS) (mOS 64 months, 95% CI, 37.18-90.81 vs. 14 months, 95% CI, 0-41.58, p=0.02). Histologic grade 1-2 and macroscopic complete resection were associated with higher PFS (PFS of five months of 90.9% vs. 33.3%, p=0.01; mPFS of 37 months, 95% CI, 4.93-69.07 vs. 10 months, 95% CI, 6.43-13.57, p=0.04, respectively). Disease recurrence with distant metastases was associated with lower OS (11 months, 95% CI, 6.1-15.9 vs. 53 months, 95% CI, 22.70-83.30, p=0.04). This study reinforces the importance of protective occupational measures. Future studies will be important to validate the best treatment strategy in the advanced stages of this disease and also to identify new prognostic and/or therapeutic target biomarkers in SNAC.
摘要：
鼻窦（SN）恶性肿瘤很少见。在SN腺癌中，最常见的是肠型腺癌(ITAC).ITAC与木材和皮革粉尘职业接触和TP53突变有关。关于其表征和治疗的信息不多。这项研究的目的是描述在我们三级医院接受治疗的鼻窦腺癌（SNACs）患者的临床病理和预后因素。回顾，我们进行了包括2004-2023年间诊断的SNAC患者在内的连续研究.收集临床病理资料,并在肿瘤标本中评估p53状态。p53状态与临床病理变量之间的关联，以及它们对生存的影响，进行了评估。总的来说,包括35个，他们中的大多数患有ITAC(91.4%)和乳头状亚型(37.5%)；大多数人遭受职业风险暴露(82.9%)。在48.6%的肿瘤中发现p53过表达。乳头状和结肠亚型的中位无进展生存期（mPFS）高于粘液性和实性亚型（mPFS37个月，95%CI，20.0-54.0，与9个月,95%CI，7.15-10.85，p=0.01）；前者还与较高的中位总生存期（mOS）（mOS64个月，95%CI，37.18-90.81与14个月,95%CI，0-41.58，p=0.02）。组织学1-2级和宏观完全切除与较高的PFS相关（五个月的PFS为90.9%与33.3%,p=0.01；mPFS为37个月，95%CI，4.93-69.07vs.10个月,95%CI，分别为6.43-13.57，p=0.04）。远处转移的疾病复发与较低的OS（11个月，95%CI，6.1-15.9vs.53个月,95%CI，22.70-83.30，p=0.04）。这项研究加强了保护性职业措施的重要性。未来的研究对于验证该疾病晚期的最佳治疗策略以及识别SNAC中的新的预后和/或治疗靶标生物标志物将是重要的。
