Axin1、Gsk-3β和CD82在皮肤鳞状细胞癌中的表达

目的：检测Axin1、Gsk-3β和CD82蛋白在皮肤鳞癌中的表达。方法：40例皮肤鳞状细胞癌（cSCC）作为实验组，15例正常皮肤组织作为对照组，采用免疫组织化学方法检测Axin1、Gsk-3β和CD82在两组中的表达。结果：Axin1在正常皮肤、cSCC I级、II级、III级的阳性表达率分别为86.7%、66.7%、40.0%、10.0%，Gsk-3β分别为80.0%、73.3%、20.0%、20.0%，CD82阳性表达率分别为73.3%、60.0%、26.7%、10.0%。在cSCC中Axin1与Gsk-3β表达呈正相关（r=0.677，P＜0.05）。结论：Axin1、Gsk-3β和CD82可能与cSCC肿瘤发展有关。     

CD147 expression in advanced cutaneous squamous cell carcinoma

Background: CD147 is upregulated in multiple cancer types, but its expression in advanced cutaneous squamous cell carcinoma (SCC) is unknown. Our purpose was to evaluate the expression patterns of CD147 and related monocarboxylate transporters (MCT1, MCT4) to determine their correlation with survival. Methods: This is a retrospective cohort study of patients with advanced stage cutaneous SCC of the head and neck who presented to a tertiary care center between 1998 and 2006 (n=50). CD147, MCT1 and MCT4 expression levels were assessed using immunofluorescence analysis of archived tumor samples and correlated with survival and clinicopathologic characteristics. Results: The majority of patients (92%, n = 46) were diagnosed with stage III disease, with 46% (n = 23) having positive regional lymph node metastasis and 8% (n = 4) with distant metastasis. Primary malignancies had an overexpression of CD147 (78%; n = 35), MCT1 (23%; n = 10) and MCT4 (47%; n = 20). In addition, there was a significant relationship between the overexpression of CD147 and node positive disease (p = 0.048). Two‐ and five‐year survival rates were 69 and 61%, respectively. There was a trend toward decreased survival in patients with overexpression of CD147 (p = 0.17), MCT1 (p = 0.11) and MCT4 (p = 0.15). Conclusion: CD147 may represent a biomarker or potential therapeutic target in advanced cutaneous SCC. Sweeny L. Dean NR, Frederick JW, Scott Magnuson J, Carroll WR, Desmond RA, Rosenthal EL. CD147 expression in advanced cutaneous squamous cell carcinoma.     

皮肤鳞状细胞癌CD44v6蛋白表达

采用免疫组织化学及图像分析技术对66例皮肤鳞状细胞癌、12例淋巴结转移灶、11例假性上皮瘤样增生、10例正常皮肤进行检测，探讨CD44v6与皮肤鳞状细胞癌的发生、发展与转移的关系。结果表明鳞状细胞癌CD44v6表达下调，且分化越差下调越明显，与是否转移及发病部位无关。提示CD44v6对维持表皮正常结构起重要作用，并与细胞增殖分化程度 有关，可以作为一个研究皮肤鳞状细胞癌发生发展的分子标志。     

Pseudocarcinomatous hyperplasia mimicking squamous cell carcinoma in a case of CD56‐positive cytotoxic T‐cell lymphoma

We present the case of an 84‐year‐old patient with a cutaneous CD56 positive cytotoxic T‐cell lymphoma associated with substantial pseudocarcinomatous hyperplasia mimicking squamous cell carcinoma (SCC). The patient presented with a 7‐month history of several progressive, ulcerated plaques on his right forearm. An initial biopsy showed changes consistent with a diagnosis of SCC for which the patient underwent surgical treatment. Several months later, the patient developed recurrent ulcerated plaques on the right forearm of which several biopsies were performed. The biopsies repeatedly showed marked pseudocarcinomatous hyperplasia resembling SCC. Deeper punch biopsies, however, showed a dense superficial and deep infiltrate of markedly atypical lymphocytes. Immunohistochemical analysis revealed strong positive staining for CD3, CD8, CD56 with negative stains for CD30 and Epstein‐Barr virus‐encoded small non‐polyadenylated RNAs (EBER). Staining for beta F1 and gamma‐delta T‐cell receptor (γδ TCR) were both negative. This constellation was most consistent with a diagnosis of cutaneous peripheral T‐cell lymphoma, unspecified in association with marked pseudocarcinomatous hyperplasia. Our case adds cutaneous peripheral T‐cell lymphoma, unspecified to the list of conditions associated with pseudocarcinomatous hyperplasia (PCH) and illustrates once again the potential pitfalls of distinguishing marked pseudocarcinomatous hyperplasia from SCC.     

Pseudoangiosarcomatous squamous cell carcinoma of the skin: A need for a more rigorous nomenclature for histopathological variants of squamous cell carcinoma

Over the years, squamous cell carcinomas (SCC) that mimicked vascular lesions have been encompassed within different classifications and the underlying etiopathogenic mechanisms have been interpreted in different ways by different authors. Here, we present a case of SCC with pseudovascular areas in the right leg of a 96‐year‐old woman with chronic venous insufficiency. Histopathological examination closely resembled an angiosarcoma, but the immunohistochemical negativity for endothelial markers and the strong positivity for the pancytokeratin marker AE1/AE3 revealed the epithelial nature of the neoplasm. After a comprehensive review of all similar previously published cases, we believe that it is necessary to separate SCC with pseudoluminal structures composed of glandular‐like areas (pseudoglandular or adenoid SCC) from those mimicking vascular lumina (pseudovascular and pseudoangiosarcomatous SCC). We would like to emphasize that acantholytic SCC, a definitive variant of SCC, can be further classified into the common or ordinary subtype of acantholytic SCC, that shows solid nests containing numerous acantholytic atypical keratinocytes without any mimickers for specific structures, and pseudoglandular, pseudovascular and pseudoangiosarcomatous subtypes when glandular or vascular structures are mimicked, respectively.     

Stromal expression of cathepsin K in squamous cell carcinoma

Background Cathepsin K (CTSK), a cysteine protease with strong collagenolytic and elastolytic properties involved in extracellular matrix turnover, may be produced by neoplastic cells as well as stromal macrophages and fibroblasts. Its expression is suggested as associated with increased invasive and metastatic potential. Objectives The aim of this study is to examine stromal expression of cathepsin K in skin tumors. Methods A series of 13 normal skin and 109 skin tumours, including 51 benign and 58 malignant epidermal tumours were tested for CTSK and Ki‐67 expression by immunohistochemical analysis. Results Stromal CTSK expression and the tumoral Ki‐67 labelling index were significantly higher in invasive squamous cell carcinoma (SCC) than in other epidermal tumours. Conclusion Cathepsin K‐positive stromal fibroblasts may play a crucial role in SCC progression by promoting extracellular matrix degradation, thereby facilitating SCC growth and invasion into surrounding tissue and vasculature. CTSK inhibitors may be a potential novel therapeutic option to decrease SCC progression.     

FOXE1 is a target for aberrant methylation in cutaneous squamous cell carcinoma

Background Several cancer‐related genes are silenced by promoter hypermethylation in skin cancers. However, to date the somatic epigenetic events that occur in cutaneous squamous cell carcinoma (SCC) tumorigenesis have not been well defined. Objectives To examine epigenetic abnormalities of FOXE1, a gene located on chromosome 9q22, a region frequently lost in SCC. Methods We investigated the methylation status of FOXE1 in 60 cases of cutaneous SCC by methylation‐specific polymerase chain reaction, and comparatively examined mRNA and protein expression by real‐time polymerase chain reaction and Western blot, respectively. Results We found a higher frequency of FOXE1 promoter hypermethylation in SCCs (55%), as compared with the adjacent uninvolved skin (12%) and blood control samples (9·5%). FOXE1 methylation was frequently seen in association with a complete absence of or downregulated gene expression. Treatment with the demethylating agent 5‐Aza‐2′‐deoxycytidine resulted in profound reactivation of FOXE1 expression. Conclusions These results indicate that FOXE1 is a crucial player in development of cutaneous SCC.     

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.     

Two cases of telangiectasia macularis eruptiva perstans demonstrated by immunohistochemistry for c-kit (CD 117)

Telangiectasia macularis eruptiva perstans (TMEP) is an uncommon form of cutaneous mastocytosis that occurs exclusively in adults. Histologically, TMEP presents with scattered mast cells lined up around the dilated capillaries and venules of the superficial vascular plexus. In some cases, the number of mast cells falls within the range observed in normal skin and therefore cannot be detected by routine histologic examination. We used immunohistochemical staining for c-kit (CD 117) for the definitive diagnosis in two patients with TMEP. One of them was successfully treated with topical application of pimecrolimus.     

Sinonasal non-keratinizing squamous cell carcinoma with nasal skin extension as the initial presentation

Sinonasal non-keratinizing squamous cell carcinoma (SCC), previously designated as transitional cell carcinoma or cylindrical cell carcinoma, is an uncommon malignant neoplasm with distinct histopathological features, considered to be a low-grade malignancy that usually occurs in elderly patients. Extensive local invasion is uncommon. Here we report a case of 90-year-old woman whose original presentation was as erythematous nasal skin nodules, biopsy of which showed a dermal tumor with features of sinonasal non-keratinizing SCC. No epidermal dysplasia was present. A subsequent computed tomography scan confirmed the presence of an endophytic tumor on the nasal sidewall. The initial presentation of sinonasal non-keratinizing SCC as a skin lesion is previously unreported to our knowledge. Diagnosis in this context requires accurate evaluation of the histopathology as well as a comprehensive knowledge of pathology specific to this anatomic location.     

CD44v6和PCNA在皮肤鳞状细胞癌中的表达及其临床意义

目的 :　研究CD4 4v6和PCNA与皮肤鳞状细胞癌 (SCC)临床病理特征的关系。方法 :　免疫组化法研究 4 8例SCC原发灶、11例淋巴结转移灶和 10例正常皮肤组织中CD4 4v6和PCNA的蛋白表达。结果 :　SCC标本中 ,CD4 4v6表达下调 (P <0 .0 1) ,分化越差下调越明显 (P <0 .0 5 ) ;PCNA表达增高 (P <0 .0 5 ) ,分化越差增高越明显 (P <0 .0 1)。二者与临床分期、淋巴结转移及发病部位均无关 (P >0 .0 5 ) ,且CD4 4v6和PCNA的表达无相关性 (r=- 0 .176 ,P >0 .0 5 )。结论 :　CD4 4v6和PCNA均可作为研究SCC发生与发展的独立的生物学指标     

The role of CD10 in distinguishing atypical fibroxanthoma from sarcomatoid (spindle cell) squamous cell carcinoma

Background: The role of CD10 needs clarification in a broader immunohistochemical battery for distinguishing atypical fibroxanthoma (AFX) from spindle cell squamous cell carcinoma (sSCC). Methods: We retrospectively reviewed 23 cutaneous spindle cell tumors previously classified as AFX (n = 11) or as sSCC (n = 12). Each tumor was stained with CD10, S‐100, p63 and two or more cytokeratin stains. Defining AFX as a diagnosis of exclusion based on multiple negative cytokeratin stains and negative p63 staining, we reclassified four squamous cell carcinomas (SCCs) as AFX. CD10 staining was reviewed and graded in all tumors. Results: Fifteen tumors were classified as AFX. Strongly positive CD10 staining was observed in all 15 AFXs, as well as four (50%) of the eight SCCs. Expression of p63 was seen in six sSCCs (75%). Conclusions: CD10 is consistently expressed by AFX. However, CD10 is also often strongly expressed by sSCC. Positive staining with p63 favors a diagnosis of sSCC. An immunohistochemical battery useful for distinguishing AFX from sSCC may include CD10, p63 and two cytokeratin markers. However, CD10 alone should not be relied upon in the distinction of these entities. Wieland CN, Dyck R, Weenig RH, Comfere NI. The role of CD10 in distinguishing atypical fibroxanthoma from sarcomatoid (spindle cell) squamous cell carcinoma.