Introduction: Acantholytic squamous cell carcinoma (aSCC) is a rare clinicopathological subtype of cutaneous squamous cell carcinoma, accounting for approximately 4.9% of all SCC cases. However, there are currently no standardized criteria for the diagnosis of aSCC. This systematic review is the first to summarize the clinical and molecular features of aSCC. Methods: A systematic search of Medline, Embase, Scopus, and PubMed was performed. All articles in English or French were included, with no restriction of publication date. All articles with original data pertaining to clinical or molecular characteristics of aSCC were included. Two reviewers screened articles and resolved conflicts. Results: Our systematic review included 52 studies on the clinical and molecular features of aSCC, including a total of 482 patients (76% male, mean age at diagnosis 68.9 years): 430 cases assessed clinical features, while 149 cases assessed molecular features. The most common location of aSCC was the head and neck (n= 329/430; 76.5%). In terms of morphology, most lesions were described as nodules (n= 93/430, 21.6%), with common surface changes being hyperkeratosis (n= 6), erosion (n= 6), ulceration (n= 5), and crusting (n= 3). With regard to dermoscopy, only six cases were noted in the literature, including findings such as ulceration (n= 3), keratin clots (n= 2), and erosions (n= 2). Thirty-four studies discussed the molecular markers of aSCC, with the most prevalent markers being cytokeratins. CD15 negativity was noted in 23 cases, while common endothelial vascular markers such as CD34 (n= 16), CD31 (n= 15), factor VIII-related antigen (n= 10), and ERG (n= 1) were often not expressed. Finally, expression of intracellular adhesion molecules (i.e., E-cadherin, CD138) was markedly decreased compared to non-acantholytic invasive SCC. Conclusions: This systematic review summarizes the clinical characteristics and molecular features of aSCC. As clinical differentiation can be difficult, clinicopathological correlation with molecular markers may help ensure proper diagnosis.
引言：棘层松解性鳞状细胞癌（aSCC）是皮肤鳞状细胞癌中一种罕见的临床病理亚型，约占所有SCC病例的4.9%。然而，目前尚无aSCC诊断的标准化标准。本系统综述首次总结了aSCC的临床和分子特征。方法：系统检索了Medline、Embase、Scopus和PubMed数据库。纳入所有英文或法文文献，不限制发表时间。所有包含aSCC临床或分子特征原始数据的研究均被纳入。由两名评审员独立筛选文献并解决分歧。结果：本系统综述共纳入52项关于aSCC临床和分子特征的研究，总计482例患者（男性占76%，诊断时平均年龄68.9岁）：其中430例评估了临床特征，149例评估了分子特征。aSCC最常见的发病部位为头颈部（n=329/430；76.5%）。形态学方面，多数皮损被描述为结节（n=93/430，21.6%），常见表面改变包括角化过度（n=6）、糜烂（n=6）、溃疡（n=5）和结痂（n=3）。皮肤镜检查方面，文献中仅记载6例，表现包括溃疡（n=3）、角蛋白栓（n=2）和糜烂（n=2）。34项研究讨论了aSCC的分子标志物，其中最普遍的标志物为细胞角蛋白。23例病例显示CD15阴性，而常见的内皮血管标志物如CD34（n=16）、CD31（n=15）、因子VIII相关抗原（n=10）和ERG（n=1）通常不表达。最后，与非棘层松解性浸润性SCC相比，细胞内黏附分子（如E-钙黏蛋白、CD138）的表达显著降低。结论：本系统综述总结了aSCC的临床特征和分子特征。由于临床鉴别可能存在困难，结合分子标志物的临床病理学分析可能有助于确保准确诊断。
肿瘤(癌症)患者之家