皮肤鳞状细胞癌整体可视化动物模型实验研究

目的:建立整体可视化皮肤癌的模型,以期实时动态观察药物与肿瘤体积、血清指数等指标的量效关系,为研究皮肤癌临床治疗提供一种更好的动物模型.方法:利用pEGFP-N1表达质粒转染皮肤鳞状细胞癌(以下简称鳞癌)SCL-1细胞,经筛选后建立稳定表达绿色荧光蛋白(EGFP)的皮肤鳞癌细胞株pEGFP-SCL-1.细胞悬液接种于裸鼠皮下,借助整体荧光成像系统实时监测细胞在接种部位生长情况.结果:皮肤鳞癌细胞pEGFP-SCL-1稳定、高效表达EGFP,裸鼠皮下注射部位种植成瘤,1周左右肿瘤向周围组织浸润;常规组织病理学检查验证了可视化模型的可靠性.结论:利用稳定转染的皮肤鳞癌pEGFP-SCL-1细胞,在注射部位种植建立整体可视化皮肤鳞癌,为研究皮肤癌治疗提供有效的阶段性监测的实验模型.     

皮肤Merkel细胞癌伴鳞状细胞癌1例

患者女,76岁。左面颊部肿物1年,明显增大1个月。皮损特点为紫红色球形肿物。皮损组织病理示:表皮见团块状鳞状上皮中-重度异型增生,突破基底膜;真皮全层见形态一致的肿瘤细胞浸润,巢状或片状分布,圆形或卵圆形,胞质少、嗜碱性,核大、散点状分布染色质,核仁明显,可见多数核分裂相。免疫组化:CK20(部分+),P63及CKH(鳞状分化的细胞+),Syn(+),CgA(+),CD56(+),LCA(-),CK7(-),S100(-)。诊断:皮肤Merkel细胞癌伴鳞状细胞癌。     

Merkel细胞癌合并原位鳞状细胞癌一例并文献复习

Merkel细胞癌是一种罕见的、具有高度侵袭性的皮肤神经内分泌癌,好发于老年人的日光暴露部位,尤其是头颈部(41％～50％),其次是四肢(32％～38％).Merkel细胞癌可与鳞状细胞癌、鲍温病、基底细胞癌等皮肤肿瘤合并发生.我们报道一例发生在非光暴露部位的Merkel细胞癌合并原位鳞状细胞癌,并对相关文献进行复习.     

Histomorphologic correlation with routine histology and optical coherence tomography

BACKGROUND: Optical coherence tomography (OCT) is a new and promising diagnostic technique for investigation of skin tumours. We describe a method that makes evaluation and definition of specific morphologic structures of skin tumours via OCT more accurate. MATERIALS AND METHOD: We investigated three patients with basal cell carcinoma and three patients with melanocytic nevi. Three-dimensional (3D) images were obtained from these skin tumours via OCT according to previously applied marks, which were tattooed with special histological marking dye after excision of the tumours. Corresponding to these marks, we investigated serial histological sections (haematoxylin&eosin staining). RESULTS: We could prove similar morphological structures both in OCT and histology. Due to tissue deformation, the compared measurements of structures like cell nests or epidermal thickness were slightly deviated. However, by this method we could prove similar tissue formations in OCT and histology. CONCLUSIONS: Due to the deformation by histological processing and slightly different sectioning levels, the comparison of histological pictures and OCT images seems difficult. Nevertheless, in two cases it was possible to demonstrate the same morphological structures with OCT imaging and histological investigation. Our method could play an important role for further evaluation of OCT images. We estimate better evaluation of OCT imaging using a 3D reconstruction method.     

Merkel cell carcinoma in situ: New insights into the cells of origin

We report a case of a 71-year-old male who presented with a small skin-coloured plaque on his cheek. Histopathology demonstrated an intraepidermal carcinoma with follicular involvement. No evidence of dermal invasion was seen. Immunohistochemical studies showed areas of positive staining for CK20, EMA and synaptophysin. Histopathology findings were found to be most consistent with a diagnosis of intraepidermal carcinoma with features of Merkel cell carcinoma in situ, in combination with a squamous cell carcinoma in situ, with follicular involvement. Recent advances and findings suggest Merkel cell polyomavirus MCPyV-positive Merkel cell carcinoma and MCPyV-negative Merkel cell carcinoma have different cells of origin from different germ layers.     

Cutaneous undifferentiated small (Merkel) cell carcinoma,that developed synchronously with multiple actinic keratoses,squamous cell carcinomas and basal cell carcinoma

Merkel Cell Carcinoma (MCC) is an uncommon undifferentiated neuroendocrine tumor, arising in skin mainly on sun-exposed areas. We present an unusual case of primary cutaneous undifferentiated small cell carcinoma that co-existed with six other lesions; 2 actinic keratoses, 3 squamous-cell carcinomas and a basal-cell carcinoma. HE stained sections revealed MCC located in the mid-dermis, co-existing with severe actinic keratosis. Immunohistochemically, the tumor cells reacted to cytokeratin 20, epithelial membrane antigen, chromogranin and neuron specific enolase. This is an unusual case of cutaneous MCC co-existing with six other different lesions. The concurrent development of MCC, squamous-cell and basal-cell carcinoma in the same patient indicates the pluripotent epidermal stem cell origin of these tumors. Further research is needed to enlighten the factors inducing this divergent differentiation.     

外毛根鞘癌11例临床与组织病理分析

11例外毛根鞘癌患者,男7例,女4例;年龄35~93岁,平均66岁。皮损均在面部、头皮曝光部位。临床表现为外生性肿物、表面可破溃。组织病理示:肿瘤组织呈实体状、分叶状、小梁状,主要由不典型的透明细胞构成,以伴有外毛根鞘角化的上皮细胞增生为特征。11例患者均经手术切除治疗。随访3年,均无复发。     

The role of radiotherapy in the management of non-melanoma skin cancer

The global incidence of non-melanoma skin cancer continues to increase as the global population ages with the highest incidence in the world occurring in Australian and New Zealand patients. There are numerous treatment options available for non-melanoma skin cancer patients of which radiotherapy is an efficacious and versatile tissue preserving non-surgical (or medical) option. In patients where excision may not be an option (medically/technically inoperable) or considered less ideal (e.g. cosmetic outcome), radiotherapy offers an excellent option. Following surgery, adjuvant radiotherapy in patients with unfavourable pathology can decrease the risk of recurrence and associated morbidity. Elderly and co-morbid patients with poor performance status can benefit from short-course hypofractionated radiotherapy in the setting where surgery is not an option. As with any modality, radiotherapy has advantages and disadvantages and it is therefore important for clinicians to appreciate these. We aim to present an update for clinicians that manage patients with non-melanoma skin cancer on the role of radiotherapy.     

Validation of a diagnostic algorithm for the discrimination of actinic keratosis from normal skin and squamous cell carcinoma by means of high‐definition optical coherence tomography

Actinic keratoses (AKs) commonly arise on sun‐damaged skin. Visible lesions are often associated with subclinical lesions on surrounding skin, giving rise to field cancerization. To avoid multiple biopsies to diagnose subclinical/early invasive lesions, there is an increasing interest in non‐invasive diagnostic tools, such as high‐definition optical coherence tomography (HD‐OCT). We previously developed a HD‐OCT‐based diagnostic algorithm for the discrimination of AK from squamous cell carcinoma (SCC) and normal skin. The aim of this study was to test the applicability of HD‐OCT for non‐invasive discrimination of AK from SCC and normal skin using this algorithm. Three‐dimensional (3D) HD‐OCT images of histopathologically proven AKs and SCCs and images of normal skin were collected. All images were shown in a random sequence to three independent observers with different experience in HD‐OCT, blinded to the clinical and histopathological data and with different experience with HD‐OCT. Observers classified each image as AK, SCC or normal skin based on the diagnostic algorithm. A total of 106 (38 AKs, 16 SCCs and 52 normal skin sites) HD‐OCT images from 71 patients were included. Sensitivity and specificity for the most experienced observer were 81.6% and 92.6% for AK diagnosis and 93.8% and 98.9% for SCC diagnosis. A moderate interobserver agreement was demonstrated. HD‐OCT represents a promising technology for the non‐invasive diagnosis of AKs. Thanks to its high potential in discriminating SCC from AK, HD‐OCT could be used as a relevant tool for second‐level examination, increasing diagnostic confidence and sparing patients unnecessary excisions.     

皮肤基底细胞癌和皮肤鳞状细胞癌270例回顾性分析

 目的:总结我院皮肤基底细胞癌(BCC)和皮肤鳞状细胞癌(SCC)临床与组织病理资料,以期提高BCC与SCC的诊断率。方法：回顾性分析2014年1月1日-2018年12月31日间我院皮肤科门诊经组织病理切片确诊的170例BCC与100例SCC患者的临床与病理资料。结果：BCC与SCC年度发病整体均呈逐渐上升趋势。BCC、SCC男女患病比例分别为0.8∶1、1∶1，好发部位均为曝光部位(头面颈部和四肢)，临床诊断与组织病理诊断符合率分别为62.4%与30.0%。临床诊断上，BCC易与脂溢性角化病(SK)、色素痣混淆；SCC易与BCC、鲍温病、光线性角化病(AK)混淆。结论：BCC和SCC为临床常见的非黑素性皮肤肿瘤，但易误诊和漏诊。临床医生对于可疑病灶应尽早行皮损组织病理检查。     

痣样基底细胞癌综合征一例

痣样基底细胞癌综合征是一种罕见的常染色体显性遗传病,以泛发性皮肤基底细胞癌和多器官发育异常为主要临床特征。本文报告1例痣样基底细胞癌综合征患者,并结合相关文献对该病的发病率、发病机制、诊断标准、治疗方法等进行讨论。