基底细胞癌和鳞状细胞癌中转化生长因子βⅠ型和Ⅱ型受体表达

目的探讨转化生长因子β(TGFβ)受体在基底细胞癌和鳞状细胞癌中表达水平的变化及其意义。方法采用实时定量PCR和SP免疫组化技术分别检测基底细胞癌、鳞状细胞癌及正常人对照皮肤中Ⅰ型和Ⅱ型TGFβ受体(TGFβRⅠ,TGFβRⅡ)mRNA和蛋白的表达。结果对18例基底细胞癌、24例鳞状细胞癌患者的皮损及正常人对照皮肤的研究显示,基底细胞癌和鳞状细胞癌皮损TGFβRⅠ和TGFβRⅡ的mRNA表达水平均显著低于正常人对照皮肤。免疫组化试验结果显示;TGFβRⅠ染色强度在基底细胞癌组、鳞状细胞癌组较正常人对照皮肤组显著降低(P<0.001);TGFβRⅡ在二组表皮肿瘤与正常人对照皮肤组问表达差异也有统计学意义(P<0.01)。结论基底细胞癌和鳞状细胞癌中TGFβ受体表达下调可能有助于这些上皮细胞起源的表皮肿瘤的形成。     

Ber EP4与EMA染色在皮肤基底细胞上皮瘤和鳞状细胞癌诊断中的意义

目的 观察BerEP4和EMA染色在皮肤基底细胞上皮瘤和鳞状细胞癌诊断中的意义.方法 用免疫组化SP法检测BerEP4和EMA在皮肤基底细胞上皮瘤、鳞状细胞癌、光线性角化病、Bowen病、脂溢性角化病、寻常疣和基底鳞状细胞癌皮损肿瘤成分及周围组织、皮肤附属腺体中的表达.结果 所有基底细胞上皮瘤和基底鳞状细胞癌肿瘤细胞呈BerEP4阳性,而鳞状细胞癌、光线性角化病、Bowen病、脂溢性角化病和寻常疣呈BerEP4阴性;多数鳞状细胞癌、Bowen病和部分光线性角化病肿瘤细胞及病变区域呈EMA阳性,而基底细胞上皮瘤、基底鳞状细胞癌、脂溢性角化病和寻常疣呈EMA阴性.结论 联合使用BerEP4和EMA能很好地协助诊断皮肤基底细胞上皮瘤、基底鳞状细胞癌、癌前病变及一些良性增生性皮肤病.     

天然抗角蛋白自身抗体抑制角质形成细胞及鳞状细胞癌细胞增殖的作用

目的 探索天然抗角蛋白自身抗体抑制角质形成细胞及鳞状细胞癌细胞增殖的作用机理。方法 经体外培养人角质形成细胞及鳞状细胞癌细胞,作用于不同浓度的天然抗角蛋白自身抗体,四甲基偶氮唑盐法检测活性,免疫组化检测增殖及凋亡相关蛋白变化。结果 天然抗角蛋白自身抗体对二者的增殖有着明显的抑制作用,且呈一定的浓度-效应关系。对二者P53、C-myc的表达具有促进作用,而对增殖细胞核抗原的表达则具有抑制作用。结论 天然抗角蛋白自身抗体对角质形成细胞及鳞状细胞癌细胞增殖的抑制作用,可能系通过调节细胞中增殖与凋亡相关蛋白的表达来实现。     

细胞角蛋白在皮肤附属器肿瘤的表达及其诊断意义

目的:观察7种细胞角蛋白(cytokeratins,CK)在皮肤附属器肿瘤的表达,并探讨其意义。方法:应用免疫组织化学S-P法对49例不同皮肤附属器肿瘤进行CK7(K72.2)、CK8(C-51)、CK10(DE-K10)、CK14(LL002)、CK17(E3)、CK18(DC10)、CK19(KS19.1)标记,观察不同细胞角蛋白的表达和分布模式。结果:49例皮肤附属器肿瘤中7种细胞角蛋白的表达和分布有所不同。毛发分化的肿瘤中CK表达多数较弥漫;而汗腺分化的肿瘤中,不同CK表达位置明显不同,每种肿瘤各有特点。结论:综合分析CK1018表达情况,可能有助于汗腺肿瘤与毛囊肿瘤的鉴别,CK10-18 支持为汗腺肿瘤,CK10 18-支持为毛囊肿瘤。     

CD147在角质形成细胞分化过程中的表达和作用

目的 明确CD147在正常角质形成细胞和鳞状细胞癌细胞分化过程中的表达和作用。方法 运用免疫组化法检测不同分化水平的寻常疣以及良性、癌前和恶性表皮肿瘤中CD147的表达。运用免疫印迹法观察CD147在培养角质形成细胞(HaCaT)和鳞状细胞癌细胞(HSC-5)钙诱导分化过程中的表达变化。并观察高钙培养和CD147抗体对HaCaT和HSC-5细胞分化相关形态学的影响。结果 寻常疣及脂溢性角化病的CD147表达方式与正常表皮相同。光线性角化病及Bowen病中部分病例阳性。鳞状细胞癌中CD147的表达随分化降低而显著升高。HaCaT及HSC-5细胞中CD147的表达均随钙诱导的分化过程而降低。CD147抗体可与高钙培养一样诱导HaCaT及HSC-5细胞的分化。结论 CD147分子是一种新的低分化角质形成细胞标志蛋白,并可能抑制正常角质形成细胞和鳞状细胞癌细胞的分化。     

基质金属蛋白酶10、金属蛋白酶组织抑制因子2等在皮肤鳞状细胞癌中的表达

目的 了解皮肤鳞状细胞癌(简称鳞癌)中基质金属蛋白酶10(MMP-10)、金属蛋白酶组织抑制因子2(TIMP-2)、Ⅳ型胶原(ColⅣ)和层粘连蛋白(LN)的表达及其与癌分化、淋巴结转移的关系。方法 用ABC免疫组化技术观察皮肤鳞癌患者的手术切除标本48例(高分化鳞癌34例,低分化鳞癌14例),其中伴淋巴结转移者12例。结果 MMP-10在低分化鳞癌中的表达明显高于高分化组(P<0.05),但其表达在淋巴结转移组与无转移组之间的差异无显着性(P>0.05).TIMP-2、ColⅣ和LN在高分化或无淋巴结转移的鳞癌中的表达明显高于低分化或有淋巴结转移者(P<0.05-0.01).结论 皮肤鳞癌中TIMP-2、ColⅣ和LN的表达与癌分化、淋巴结转移有关,而MMP-10表达仅与癌分化有关。     

手术治疗162例基底细胞癌临床分析

目的 探讨基底细胞癌的一般发病规律、好发部位、常见复发部位和手术治疗的治愈率.方法 对162例基底细胞癌患者分别采用不同术式治疗的情况进行回顾性分析.结果 162例基底细胞癌中,年龄50岁以上者119例,占73.5%;肿瘤单发者156例,占96%.肿瘤好发部位依次是面颊、鼻部、头皮、躯干、口周、眼睑等.肿瘤复发率为6.3%(13/162),易复发部位依次为鼻部、口周,其次是眼睑、头皮.结论 手术治疗基底细胞癌治愈率高,复发率低,仍应作为本病首选治疗方法.手术方式与疗效、复发间无明显相关性.     

生存素和端粒酶逆转录酶在皮肤肿瘤中的表达

目的 研究皮肤肿瘤凋亡抑制基因生存素与人端粒酶逆转录酶(hTERT)的表达及相互关系.方法 免疫组化SP法检测17例鳞状细胞癌(鳞癌)、21例基底细胞癌(基癌)、19例鲍恩病、25例脂溢性角化病和13例正常人皮肤组织中生存素表达水平;原位杂交法检测上述组织中hTERT mRNA的表达水平;分析皮肤肿瘤中生存素与hTERT mRNA表达的相关性.结果 ①在鳞癌、基癌、鲍恩病中生存素及hTERT mRNA表达的阳性率均较正常人皮肤中显著增加;②脂溢性角化病中生存素表达的阳性率与正常人皮肤组织中比较差异有统计学意义,但hTERT mRNA表达的阳性率与正常人皮肤组织中比较差异无统计学意义;③鳞癌、基癌、鲍恩病中生存素阳性率及hTERT mRNA阳性率之间均呈显著正相关,脂溢性角化病中两者阳性率之间无显著相关性.结论 生存素与皮肤肿瘤发病关系密切,在鳞癌、基癌、鲍恩病中生存素与hTERT mRNA的表达具有一定的相关性.     

皮肤鳞状细胞癌中Basigin/CD147表达与肿瘤进展的相关性

目的 探讨Basigin/CD147在皮肤鳞状细胞癌(鳞癌)进展中的作用及其机制.方法 运用免疫组化方法检测36例浸润和复发/转移情况不同的原发皮肤鳞状细胞癌标本中Basigin和基质金属蛋白酶(MMPs)的表达.运用免疫印迹和免疫荧光法观察Basigin在培养角质形成细胞和鳞状细胞癌细胞中的表达和定位.结果 有浸润和伴复发/转移的原发鳞癌肿瘤细胞中Basigin、MMP-1、MMP-2和MT1-MMP的表达显着增高.肿瘤细胞周围成纤维细胞中MMP-1、MMP-2和MT1-MMP的表达亦与原发鳞癌的复发/转移密切相关.肿瘤细胞膜上Basigin的表达与成纤维细胞中MMP-1、MMP-2、MMP-3和MT1-MMP的表达间显着相关.增高表达的Basigin主要分布于鳞癌细胞膜的微绒毛上.结论 鳞癌细胞膜上增高表达的Basigin/CD147可能与周围成纤维细胞作用,诱导其MMPs产生,并通过这一机制在鳞癌进展中发挥重要作用.     

肿瘤相关基因NET-1在皮肤鳞状细胞癌中的表达

目的 研究NET-1蛋白在皮肤鳞状细胞癌(SSCC)中表达的临床与病理意义.方法 通过基因生物工程技术制备针对NET-1蛋白大部分细胞外区的多克隆抗体,应用免疫组化SP法检测NET-1基因蛋白在56例SSCC组织、50例皮肤上皮内瘤变(SINⅠ～Ⅲ级)及10例正常人皮肤(NS)组织中的表达.结果 ①NET-1蛋白阳性表达定位清晰,为细胞膜和/或胞质,组织背景非特异性反应弱或无;②NET-1仅表达在SINⅢ中上皮全层,阳性率为93.75%,在SSCC中表达阳性率为96.43%.NET-1在SSCC和SINⅢ中的阳性率显著高于SINⅠ～Ⅱ级,其阳性率为44.22%.③SSCC细胞不同Ki67表达强度、浸润深度和皮肤肿瘤TNM分期中NET-1表达除有显著筹异外,还与NET-1阳性表达呈显著正相关.在不同SSCC组织类型中,疣状鳞癌与梭形细胞鳞癌和经典鳞癌之间NET-1表达有显著差异.结论 本文设计合成的NET-1抗体在SSCC石蜡标本中定位良好,可能是一个新的诊断SSCC的辅助组织学标记.     

Follicular squamous cell carcinoma of the skin: a poorly recognized neoplasm arising from the wall of hair follicles

BACKGROUND: In the last decades, a number of clinicopathologic subtypes of squamous cell carcinoma (SCC) of the skin, ranging from highly aggressive tumors with a tendency to recur and metastasize to neoplasms with a favorable prognosis, have been described. SCCs arising from the wall of hair follicles have been briefly mentioned by some authors but never reported in a series. METHODS: Cases of SCC arising from the wall of hair follicles were collected from the files of two large German Centers for Dermatopathology and analyzed clinicopathologically and immunohistochemically. RESULTS: Sixteen cases of SCC developing in hair follicles were found among more than 7000 cases of cutaneous SCC reviewed. In most cases, tumors arose on sun-damaged skin of the face of elderly persons. There was a male predominance (11/5). The most common clinical diagnosis was basal cell carcinoma (BCC). Microscopically, tumors developed in the upper part of hair follicles without or with focal involvement of the overlying epidermis at the border with the involved follicle. Immunohistochemically, tumors were positive for cytokeratin and negative for a battery of immunomarkers, including antibodies against the most common carcinogenic human papillomaviruses (HPV) of the skin. Most tumors were excised by simple excision. In two cases, a recurrence was noted after incomplete excision. No further recurrences or metastasis have been noted after a follow-up period ranging from 11 months to 12 years. CONCLUSION: SCC of the hair follicle represents a poorly recognized but distinctive subset of SCC of the skin that should be considered in the differential diagnosis of other cutaneous epithelial tumors. The term follicular SCC (FSCC) is proposed for this neoplasm.     

Expression of the hair stem cell-specific marker nestin in epidermal and follicular tumors

Nestin, a marker of neural stem cells, is expressed in the stem cells of the mouse hair follicle. The nestin-expressing hair follicle stem cells give rise to the outer-root sheath. Nestin-expressing hair follicle stem cells that are negative for the keratinocyte marker keratin 15 (K15) can differentiate into neurons, glia, keratinocytes, smooth muscle cells, and melanocytes in vitro. Recent studies suggest that the epithelial stem cells are important in tumorigenesis. In this study, we immunohistochemically examined the expression of three hair follicle stem cell and progenitor cell markers, nestin, K15, and CD34, in normal human epidermis and hair follicles and in epidermal and follicular tumors, trichilemmoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). In normal human skin, the cells in the epidermal basal layer were positive for K15 and negative for nestin and CD34. The hair follicle cells below the sebaceous glands were also positive for nestin and K15 and negative for CD34. The outer-root sheath cells under this area could be divided into three parts: an upper part of the outer-root sheath cells that was partially positive for nestin and positive for K15 and negative for CD34; a middle part that was CD34-positive and K15-negative; and a lower part that was positive for K15 and negative for CD34. In the tumor tissues, nestin immunoreactivity was observed in trichilemmoma but not in BCC. Also, immunoreactivity for K15 was strong in BCC and weak in trichilemmoma, and SCC was negative for nestin and partially positive for K15. No CD34 immunoreactivity was observed in any of the cases. These results suggested that trichilemmoma originates in the nestin-positive/K15-positive/CD34-negative outer-root sheath cells below sebaceous glands, BCC tumor cells from the more mature nestin-negative/K15-positive/CD34-negative outer-root sheath cells, and SCC from the nestin-negative/K15-positive/CD34-negative keratinocytes of the basal cell layer in the epidermis.     

Expression Profile of CD10, BCL-2, p63, and EMA in the Normal Skin and Basal Cell Carcinomas: An Immunohistochemical Reappraisal

BackgroundBasal cell carcinoma (BCC) is common cutaneous malignancy.AimsTo examine the expression patterns of CD10, p63, BCL-2, and epithelial membrane antigen (EMA) proteins in BCC.Materials and methodsWe used immunohistochemistry to evaluate the expression pattern of these proteins in 45 BCC specimens and their adjacent normal skin.ResultsWe found variations in the expression pattern of these proteins among normal skins and BCC. In normal skins, we found strong EMA cytoplasmic expression (adnexal structures). A strong nuclear p63 protein expression was found in basal and some suprabasal keratinocytes, external root sheath cells of the hair follicles, basal cells of the sebaceous glands, and in sweat glands.CD10 protein expression was seen in peri-adnexal mesenchymal spindle cells and myoepithelial cells of sweat glands.BCL-2 protein expression was confined to the basal cell keratinocytes, epidermal melanocytes, outer root sheath, and infundibulum of the hair follicle. In BCC, we found p63 (diffuse, strong nuclear staining), CD10 (focal, moderate cytoplasmic reactivity), and BCL-2 (focal, moderate cytoplasmic reactivity) protein expression in the neoplastic cells. BCC was consistently negative for EMA (except in areas of squamous differentiation).ConclusionsThere is an altered expression of these proteins in BCC. The underlying molecular mechanisms are open to further investigations.     

[Artículo traducido] Perfil de expresión de CD10, BCL-2, p63 y EMA en los carcinomas normales de piel y de células basales: Revaloración inmunohistoquímica

BackgroundBasal cell carcinoma (BCC) is common cutaneous malignancy.AimsTo examine the expression patterns of CD10, p63, BCL-2, and epithelial membrane antigen (EMA) proteins in BCC.Materials and methodsWe used immunohistochemistry to evaluate the expression pattern of these proteins in 45 BCC specimens and their adjacent normal skin.ResultsWe found variations in the expression pattern of these proteins among normal skins and BCC. In normal skins, we found strong EMA cytoplasmic expression (adnexal structures). A strong nuclear p63 protein expression was found in basal and some suprabasal keratinocytes, external root sheath cells of the hair follicles, basal cells of the sebaceous glands, and in sweat glands.CD10 protein expression was seen in peri-adnexal mesenchymal spindle cells and myoepithelial cells of sweat glands.BCL-2 protein expression was confined to the basal cell keratinocytes, epidermal melanocytes, outer root sheath, and infundibulum of the hair follicle. In BCC, we found p63 (diffuse, strong nuclear staining), CD10 (focal, moderate cytoplasmic reactivity), and BCL-2 (focal, moderate cytoplasmic reactivity) protein expression in the neoplastic cells. BCC was consistently negative for EMA (except in areas of squamous differentiation).ConclusionsThere is an altered expression of these proteins in BCC. The underlying molecular mechanisms are open to further investigations.     

皮肤鳞状细胞癌和基底细胞癌癌细胞表达CD54抗原的免疫电镜研究

为探讨皮肤鳞状细胞癌（鳞癌）和基底细胞癌（基癌）癌细胞上是否低水平表达CD54抗原,应用低温聚合、包埋后染色的胶体金免疫电镜技术,对3例鳞癌和3例基癌CD54免疫组化色阴性的癌细胞进行了研究。在3例鳞癌和3例基癌中,各2例癌细胞表面及突起处观察到CD54胶体金颗粒的存在;其中1例鳞癌张力微丝－桥粒复合体处还可见CD54胶体金颗粒分CD54抗原。该结果可解释皮肤鳞癌和基癌临床上可发生转移,但发生率较低的机理,值得进一步研究。     

p73蛋白在正常人皮肤和表皮肿瘤中的表达

目的 探讨p73蛋白在正常人皮肤和不同表皮肿瘤皮损中的表达及意义。方法 应用免疫组化方法检测19例脂溢性角化病、16例基底细胞癌、11例Bowen病、5例鳞状细胞癌及10例正常人皮肤p73、p53、Ki67的表达。结果 在正常人表皮基底层、毛囊外毛根鞘最外层基底样细胞和皮脂腺生发细胞有p73的表达;在基底细胞癌和脂溢性角化病的基底样细胞、Bowen病中异形性明显的瘤细胞p73呈高表达,鳞状细胞癌和脂溢性角化病中的鳞状细胞呈弱阳性或不表达。脂溢性角化病、Bowen病、基底细胞癌、鳞状细胞癌之间p73蛋白表达差异有统计学意义(H=12.71,P<0.01),其中基底细胞癌的表达最强。Ki67在皮肤肿瘤之间差异也有统计学意义(H=14.12,P<0.01),但p53差异无统计学意义(H=2.058,P>0.05)。在各组样本中,p73的表达与p53、Ki67无显著相关性(P>0.05)。结论 p73蛋白可能在皮肤分化中起重要作用。     

Does the peritumoral stroma of basal cell carcinoma recapitulate the follicular connective tissue sheath?

Background: There are compelling embryologic and anatomic relationships within adnexal tumors. However, these are mostly perceived within the epithelial component while the stromal component of the tumors is frequently overlooked. In postnatal skin, nestin is almost exclusively expressed in the perifollicular mesenchyme. This study examines the expression of this neuroepithelial stem cell protein in trichoblastoma/trichoepithelioma and in basal cell carcinoma (BCC), which is increasingly being viewed as follicular in nature. Methods: We employed standard immunohistochemical methods with three different antibodies to examine the expression of nestin in 25 BCCs and compared the staining pattern with that of 7 trichoblastomas and 11 trichoepitheliomas. Results: Nestin is expressed in the peritumoral stroma of all tumors examined and is limited to the immediate layer of mesenchymal cells surrounding the tumor epithelium. In BCC, nestin‐immunoreactive cells are found as a sheath of thin, spindled fibroblasts, while reactive cells are plump in trichoepitheliomas/trichoblastomas. Conclusions: We postulate that the peritumoral stroma of BCC imitates the perifollicular connective tissue sheath, while in contrast that of trichoepithelioma/trichoblastoma is similar to the papillary and immediate peripapillary follicular mesenchyme. Further functional and animal experimental studies are needed to test this hypothesis. Sellheyer K, Krahl D. Does the peritumoral stroma of basal cell carcinoma recapitulate the follicular connective tissue sheath? A comparative analysis of nestin expression in basal cell carcinoma, trichoepithelioma, trichoblastoma and the hair follicle.     

Carcinoma arising in a proliferating trichilemmal cyst expresses fetal and trichilemmal hair phenotype

Carcinomas that arise in a proliferating trichilemmal cyst (PTC) have been described under a variety of names. Monoclonal antibodies (mAbs) indicating follicular differentiation have become available and were used here in two rare tumors with uncommon biologic behavior. To further elucidate the histogenesis of carcinomas arising in a PTC, mAbs to hair follicle stem cells and to hair follicle differentiation-specific cytokeratins (mAbs to cytokeratin [CK] 7, CK8, CK18, and CK19 as well as mAbs to CD8/CK15 and CD34) were studied on paraffin-embedded sections of two cases of carcinoma arising in a PTC, one anaplastic carcinoma, and one poorly differentiated squamous cell carcinoma (SCC). For comparison, concurrent PTCs and trichilemmal cysts as well as four SCCs from controls were studied. The anaplastic carcinoma showed expression of CK7, indicating a fetal hair root phenotype, and expression of CD34, indicating trichilemmal differentiation. In contrast, the poorly differentiated SCCs as well as the control SCCs stained negative for most of the mAbs applied. Expression of fetal and trichilemmal hair follicle phenotypes suggests differentiation from hair stem cells and might explain differences in biologic behavior.     

Immunohistochemical distribution of adult T-cell leukemia-derived factor/thioredoxin in epithelial components of normal and pathologic human skin conditions.

Tissues from normal human skin and various skin diseases were studied with the immunoperoxidase technique using an antibody to adult T-cell leukemia-derived factor (ADF), a homologue of human thioredoxin. Normal human skin showed positive immunostaining for ADF/thioredoxin in the outer root sheath of hair follicle, sebaceous glands, and secreting components of apocrine and eccrine sweat units, but not in the unexposed interfollicular epidermis and other parts of both hair follicles and the sweat units. Immunoreactivity of benign skin tumors gave similar distribution to their normal counterparts; trichilemmal cyst, nevus sebaceus, senile sebaceous hyperplasia, and mixed cell tumor were positive for immunostaining, whereas epidermal cyst and pilomatricoma were not. No immunoreactivity was detected in malignant skin tumors such as basal cell carcinoma and poorly differentiated squamous cell carcinoma. Solar keratosis, well-differentiated squamous cell carcinoma, some of metastatic lesions of squamous cell carcinoma, and extramammary Paget's disease reacted with the antibody. These immunoreactivities reflected numerous functions of thioredoxin in higher organisms. Our findings suggest that the expression of ADF/thioredoxin in both normal and abnormal human skin is related to epithelial cell differentiation.