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Common oncogene copy number amplifications have been found in SOX2, PDGFRA, EGFR, FGFR1 and CCND1. Deletions were observed in tumor suppressors such as CDKN2A, PTEN and NF1. |
Some alterations such as the ones affecting TP53 and CDKN2A are shared by lung SCC and the other most common type of NSCLC, lung adenocarcinoma. Conversely, the two main driver oncogenes of the latter, EGFR and KRAS, are rarely mutated in lung SCC. |
==== Somatically altered pathways ==== |
Many of the gene mutations and copy number alterations occur in pathways whose deregulation seems to be important for the initiation and progression of the tumor. Specifically, KEAP1 and NFE2L2 belong to the oxidative stress response pathways; alterations in these genes tend to occur in a mutually exclusive fashion, an... |
Alterations in the receptor tyrosine kinase pathway are also common but not as widespread as for the adenocarcinoma type. |
==== 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... |
== Diagnosis == |
Early squamous-cell carcinoma of the lung (generally as squamous-cell carcinoma in situ) is asymptomatic and may only appear as an incidental imaging finding on CT scan or magnetic resonance imaging as a lung nodule. Eventually, it becomes symptomatic, usually when the tumor mass begins to obstruct the lumen of a major... |
Cytopathology may detect atypical cells from cytologic smear test of sputum, bronchoalveolar lavage, or samples from endobronchial brushings. |
Histopathology requires at least a lung biopsy. On such exams, these tumors range from well differentiated, showing keratin pearls and cell junctions, to anaplastic, with only minimal residual squamous-cell features. Tumor cells that show keratinization and appear darkly stained (hyperchromatic) with a pinkish hue (eos... |
=== Classification === |
The 2015 WHO classification of lung tumors divided squamous cell lung carcinomas into 3 categories: keratinizing, non-keratinizing and basaloid. Keratinizing SCC harbor features of keratinization; non-keratinizing SCC lack such features but show other squamous markers, such as p40 and p63; finally, basaloid SCC is a ra... |
== Treatment == |
Treatment of lung squamous-cell carcinoma depends on many factors including stage, resectability, performance status and genomic alterations acquired by the individual tumor. |
Radiation therapy can be used for lung SCC. It may serve as the main treatment if surgery isn't possible due to the tumor's location, the patient's health, or personal choice. It's also used after surgery to target any remaining cancer cells or before surgery to help shrink the tumor. When the cancer has spread to oth... |
Therapy of early-stage SCC mimics that of other histologic types of NSCLC. Early stage (I, II and IIIA) lung SCC are typically resected surgically, and cytotoxic chemotherapy and/or radiation may be used as an adjuvant therapy following surgery. In cases of stage IA lung cancer, chemotherapy is usually not part of the ... |
Development of targeted therapies has been less rapid for lung SCC with respect to adenocarcinoma, as ALK rearrangements and EGFR mutations targetable with receptor tyrosine kinase inhibitors are much less frequent in the former compared to the latter. |
Immunotherapy is showing promising results for NSCLC, and anti-PD-1 agent nivolumab has been approved by the US Food and Drug Administration (FDA) for lung SCC. |
== Epidemiology == |
According to the National Cancer Institute, lung cancer ranks as the third most commonly diagnosed cancer—following breast and prostate cancer—but it is the leading cause of cancer-related deaths. Lung squamous-cell carcinoma is the second most common histologic type of lung cancer after adenocarcinoma, reaching 22.6% ... |
As much as 91% of lung SCC has been found to be attributable to cigarette smoking. Incidence is greater in men than in women. |
== References == |
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6c4a327ca5837b57ed3eab2fdb5baa0a1cb21521884fb652908602519ab2e591 wp-lung-scc.txt |
TITLE: Usual ductal hyperplasia |
REVID: 1217265694 |
Usual ductal hyperplasia (UDH) is a benign lesion of the breast wherein cells look very similar to normal. It is a spectrum of changes that can range from minimal stratification of cells to proliferations that are just short of atypical ductal hyperplasia. |
== Histopathology == |
Usual ductal hyperplasia is typically a cohesive proliferation with haphazard, jumbled cell arrangement or streaming growth pattern. Cells have mild variation in cellular and nuclear size and shape. |
== References == |
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039bf4e420d5bacec0495f09e840fd816342dd9650797b0349e116f452daf10f wp-udh.txt |
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