环氧化酶-2在表皮肿瘤中的表达

目的 探讨环氧化酶-2在不同表皮肿瘤中的表达及意义。方法 选择鳞状细胞癌8例、基底细胞上皮瘤10例、Bowen病8例和脂溢性角化病12例,运用免疫组化方法观察肿瘤细胞中环氧化酶-2的表达。结果 与正常表皮相比,环氧化酶-2在鳞状细胞癌、Bowen病、基底细胞上皮瘤中的表达明显上调,尤其以鳞状细胞癌中的表达最强。而环氧化酶-2在脂溢性角化病中的表达与正常人皮肤的表达近似。结论 环氧化酶-2表达的上调可能在表皮肿瘤的发生发展中发挥一定作用。     

桥粒芯糖蛋白1和2在不同表皮肿瘤中的表达

目的 探讨桥粒相关蛋白与皮肤肿瘤的关系,对桥粒芯糖蛋白1和2在鳞状细胞癌、日光性角化病、角化棘皮瘤、脂溢性角化病中的表达水平进行了比较研究.方法 免疫组化染色方法.结果 桥粒芯糖蛋白1和2在正常皮肤表皮全层细胞间呈现较强的染色,鳞状细胞癌组织中表达显着减弱或完全无表达,日光性角化病表皮正常区域表达正常或下调,细胞间变区域无染色,角化棘皮瘤和脂溢性角化病表皮中表达水平与正常皮肤的表达非常近似.结论 桥粒芯糖蛋白1和2在恶性皮肤癌中表达下调,可能与皮肤肿瘤的侵袭和转移有关.     

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。     

基底细胞癌75例临床病理分析

目的探讨皮肤基底细胞癌(BCC)组织病理特征及其鉴别诊断,以对治疗方案的选择提供指导。方法分析75例患者的临床及组织病理资料。结果按组织病理分型,实性BCC 33例,色素性BCC 14例,浅表性BCC 8例,硬斑病样BCC 5例,囊性BCC 3例,角化性BCC 4例,腺样BCC 2例,纤维上皮瘤性BCC 2例,实体与其他混合型4例。以上各型易与脂溢性角化病、光线性角化病、色痣、角化棘皮瘤、黑素细胞瘤、Bowen病等鉴别。结论各型皮肤基底细胞癌均具有明确的组织病理学特征,易与其他皮肤疾病鉴别。外科手术仍为首选治疗,Mohs显微外科手术在预防复发和美观方面更具优势,光动力疗法对表浅型BCC疗效较佳。     

桥粒芯糖蛋白1在不同表皮肿瘤中表达的研究

目的：了解桥粒芯糖蛋白1与表皮肿瘤的病理及生物学行为之间的关系。方法：采用过氧化物酶标记的链霉卵白素免疫组织化学染色方法，检测了桥粒芯糖蛋白1(Dsgl)在鳞状细胞癌、基底细胞癌、Bowen病、日光角化病、角化棘皮瘤、脂溢性角化病及正常皮肤中的表达。结果：Dsgl在正常表皮中显著表达；在鳞状细胞癌和基底细胞癌的肿瘤组织中表达显著减弱或消失；在Bowen病和日光角化病细胞间变区域无表达；在绝大多数角化棘皮瘤、脂溢性角化病中的表达为强而连续的胞膜染色，与正常表皮中的表达相似。结论：皮肤恶性肿瘤中Dsgl的表达显著减弱或消失，可能与肿瘤的侵袭性和转移有关，Dsgl可能对表皮良、恶性肿瘤的鉴别诊断具有一定价值。     

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.     

脂溢性角化病、基底细胞癌和鳞状细胞癌中几种Smad蛋白质表达的检测

目的：探讨转化生长因子（TGF）-β信号转导途径中Smad1、Smad2、Smad3（Smad1／2／3）,磷酸化Smad2,磷酸化Smad3（p-Smad2／3）Smad4蛋白在脂溢性角化病、基底细胞癌和鳞状细胞癌中的表达特点及其意义。方法：采用EliVision^TMplus免疫组化技术分别检测脂溢性角化病、基底细胞癌、鳞状细胞癌以及正常对照皮肤中Smad1／2／3、p-Smad2／3、和Smad4的表达情况。结果：Smad1／2／3、p-Smad2／3和Smad4蛋白在脂溢性角化病、基底细胞癌和鳞状细胞癌中的表达较正常表皮显著降低。结论：脂溢性角化病、鳞状细胞癌和基底细胞癌中Smadl／2／3、p-Smad2／3和Smad4蛋白表达降低可能通过阻断TGF—B信号转导,有助于上述表皮肿瘤的形成和发展。     

埃兹蛋白在皮肤鳞状细胞癌、基底细胞上皮瘤、脂溢性角化病中的表达及临床意义

目的 探讨埃兹蛋白（ezrin）在脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌中的表达及其与临床病理参数之间的相关性。方法 采用免疫组化法（SP法）检测36例皮肤鳞状细胞癌、27例基底细胞上皮瘤和20例脂溢性角化病、10例正常人皮肤中埃兹蛋白表达水平。结果 埃兹蛋白在正常人皮肤、脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌中的阳性率分别为20.0%,25.0%,66.7％和91.3%,除脂溢性角化病组外,各肿瘤组与正常人对照组比较,阳性率差异均有统计学意义（H = 40.061,P < 0.01）。埃兹蛋白表达水平与皮肤肿瘤良恶性、与皮肤鳞状细胞癌的病理分级及肿瘤有无淋巴结转移均呈正相关（r分别为0.87,0.80,0.89）。COX回归显示,埃兹蛋白表达水平是皮肤鳞状细胞癌预后的独立影响因素之一。结论 脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌组织中埃兹蛋白阳性表达水平与皮肤肿瘤的良恶性、皮肤鳞状细胞癌病理分级及有无淋巴结转移有关。     

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。     

角化性皮肤病

脂溢性角化病、基底细胞癌和鳞状细胞癌中几种Smad蛋白质表达的检测；播散性浅表性光线性汗孔角化病一家系调查；耳后毛囊角化病1例；掌跖角化-牙周破坏综合征1例。     

Distribution of Lectin UEA-I in Trichilemmal Carcinoma,Squamous Cell Carcinoma,and Other Epithelial Tumors of the Skin

Trichilemmal carcinoma (TLC) is a cutaneous appendage tumor. In some cases, the histological distinction between TLC and squamous cell carcinoma (SCC) is difficult with hematoxylin & eosin staining. In the present study, in order to establish a simple and reliable method for distinguishing between TLC and SCC, we examined the lectin Ulex europaeus agglutinin-I (UEA-I)-binding patterns of TLC (4 cases), SCC (10 cases), malignant proliferating trichilemmal cyst (MPTC) (3 cases), Bowen's disease (4 cases), Bowen's carcinoma (4 cases), actinic keratosis (4 cases), basal cell carcinoma (8 cases), and eccrine porocarcinoma (1 case). In normal skin samples, UEA-I was strongly positive in the outer root sheath cells of the hair follicle and weakly positive in the granular layers of the epidermis. UEA-I stained the tumor cells of TLC clearly and some MPTC and Bowen's disease cells weakly. This result indicates that histochemical staining with UEA-I is a simple and useful method for distinguishing between TLC and SCC of the skin.     

光线性角化病159例与皮肤鳞状细胞癌51例临床病理特征分析

目的了解滇东地区光线性角化病与鳞状细胞癌的疾病构成比、一般情况和临床病理特征。方法采用回顾性研究方法对曲靖市第一人民医院皮肤科2014年1月-2018年12月共5年行病理检查确诊的光线性角化病和皮肤鳞状细胞癌患者的临床和病理检查资料进行分析。结果159例光线性角化病(AK)与51例(SCC)鳞状细胞癌患者中女性多于男性,光线性角化病和鳞状细胞癌的发病平均年龄分别为(66.32±14.63)岁和(65.00±16.26)岁。光线性角化病和鳞状细胞癌患者皮损发生于曝光部位的分别占98.11%和78.43%。51例鳞状细胞癌患者中,有3例均是光线性角化病继发鳞状细胞癌,均为女性,年龄均>70岁,发病部位均为曝光部位。5年确诊光线性角化病患者占总病检患者的构成比相对稳定,其中鳞状细胞癌有所波动。AK病理分型分为肥厚型98例(61.64%)、萎缩型26例(16.35%)、棘层松解型12例(7.55%)、色素型9例(5.66%)、苔藓样型9例(5.66%)、鲍温样型5例(3.14%);SCC病理分级Ⅰ级39例(76.47%)、Ⅱ级11例(21.57%)、Ⅲ级1例(1.96%)、Ⅳ级0例。光线性角化病与鳞状细胞癌中临床诊断与病理诊断符合率分别为61.00%和56.86%,易被误诊为其他疾病。结论滇东地区光线性角化病与鳞状细胞癌以中老年女性为主,主要位于头面颈部等曝光部位,与紫外线关系密切,其中发生于曝光部位、皮损多样、病程长的老年女性光线性角化病患者易继发鳞状细胞癌,但临床病理诊断符合率较低,需引起重视。     

Differential expression of ezrin in epithelial skin tumors: cytoplasmic ezrin immunoreactivity in squamous cell carcinoma

Background Ezrin is a cytoskeleton linker protein that is actively involved in regulating the growth and metastatic capacity of cancer cells. The purpose of the study was to assess the expression pattern of ezrin in normal skin and various epithelial neoplasms. Methods We used immunohistochemical techniques to examine the expression of ezrin in paraffin‐embedded tissues of squamous cell carcinoma (n = 23), basal cell carcinoma (n = 10), Bowen’s disease (n = 10), actinic keratosis (n = 10), keratoacanthoma (n = 9), seborrheic keratosis (n = 5), psoriasis vulgaris (n = 5), and normal control skin (n = 5). Results In Bowen’s disease, actinic keratosis, keratoacanthoma, and seborrheic keratosis, ezrin was dominantly expressed in the cell membrane except for the cornified layer. In squamous cell carcinoma (SCC) specimens, the percentage of ezrin‐positive cells was increased compared with Bowen’s disease, actinic keratosis, keratoacanthoma, and seborrheic keratosis. Especially in SCC samples, ezrin expression was markedly expressed in the cytoplasm. In addition, there was a correlation between the pattern of ezrin expression and tumor differentiation in SCC. Basal cell carcinoma showed intense and diffuse staining especially in the solid growth pattern. Conclusions Our findings suggest that dysregulation of ezrin may be important in the development of cutaneous epithelial malignancies and tumor grade. We suggest that the cytoplasmic localization of ezrin may be useful in the diagnosis of skin SCC.     

Two Cases of Basal Cell Carcinoma Arising in Seborrheic Keratosis

The present study reports two cases of basal cell carcinoma arising in seborrheic keratosis. The first case is a seventy-three-year-old female who presented with a blackish nodule arising from a pigmented lesion on her chest. Histopathological analysis of the nodule and the pigmented lesion revealed a basal cell carcinoma with hair follicular differentiation and an acanthotic seborrheic keratosis, respectively. The second case is a seventy-year-old female with a blackish nodule arising from a pigmented lesion on her back. Histological analysis of the nodule revealed an atypical basaloid cell mass surrounded by a seborrheic keratosis lesion. In addition to the coexisting seborrheic keratosis with the basal cell carcinoma, a basaloid follicular hamartoma that showed muliple hamartomatous hair follicles or small cysts replaced by a branching cord or lace-like network of basaloid cells surrounded by fibrovascular stroma was identified. We concluded that both cases presented a rare combination of a seborrheic keratosis which underwent a malignant change to basal cell carcinoma. It appears that both basal cell carcinomas and seborrheic keratosis may derive from a similar source: pluripotential cells of either the epidermis or hair follicle epithelium.     

Carcinogenesis in porokeratosis. Evidence for a role relating to chronic growth activation of keratinocytes.

Porokeratoses are known to give rise to squamous and basal cell carcinomas. In this study, we examined 15 lesions of porokeratosis immunohistochemically for evidence of aberrant keratinization using several markers of keratinocyte (KC) maturation and differentiation, including involucrin, filaggrin, cytokeratins, and the growth activation marker psi-3. The staining patterns obtained were compared with several non-premalignant parakeratotic skin lesions including psoriasis, pityriasis rosea, pityriasis rubra pilaris, irritated seborrheic keratosis, atopic dermatitis, seborrheic dermatitis, and verruca vulgaris. The centers of porokeratoses stained in a pattern identical to that observed in other premalignant keratinocytic lesions including actinic keratoses, recessive dystrophic epidermolysis bullosa, and nonhealing wounds. KCs beneath the cornoid lamella (CL) stained in a pattern similar to that observed in squamous cell carcinomas. KCs peripheral to the CL in the epidermis showed a normal staining pattern. The control non-premalignant parakeratotic lesions displayed a variety of staining patterns, but none showed a pattern identical to that observed in porokeratosis. The failure of KCs in porokeratoses to mature and differentiate normally may be related to the increased incidence of carcinomas associated with these lesions.     

Immunohistochemical demonstration of carcinoembryonic antigen and related antigens in various cutaneous keratinous neoplasms and verruca vulgaris

Carcinoembryonic antigen (CEA), which is a well-known marker for the normal sweat gland apparatus and its neoplasms in the skin, was recently demonstrated in sebaceous neoplasms. The aim of this study was to examine the expression of CEA and related antigens in the other cutaneous keratinous neoplasms and verruca vulgaris. Normal adult skin, squamous cell carcinoma (SCC), senile keratosis, Bowen's disease, basal cell carcinoma (BCC), seborrhoeic keratosis and verruca vulgaris were stained immunohistochemically with a panel of monoclonal and polyclonal antibodies that recognize different epitopes of CEA and related molecules. Localization of the antigens was compared with that of involucrin and proliferating cell nuclear antigen. The strongest expression of CEA-related antigens, other than non-specific cross-reacting antigen (NCA) -50/90, was seen in SCC and verruca vulgaris, while no detectable expression was seen in BCC. Senile keratosis, Bowen's disease and seborrhoeic keratosis showed the predominance of the CEA-related antigens over CEA weakly expressed. Strong expression of both CEA and NCA-50/90 was seen only in SCC. All the expressions were limited to the cells situated in the upper epidermal cell layers of the tumours, at the centre of tumour islands in SCC and along the pseudohorn cysts in seborrhoeic keratosis, where involucrin was coexpressed. We suggest that CEA and related antigens are not only markers for sweat gland differentiation in the skin, as currently accepted, but are also expressed in various cutaneous keratinous neoplasms and verruca vulgaris. The expression may correlate with the terminal differentiation of the tumour cells, the strong coexpression of CEA and NCA-50/90 may correlate with the malignant potential of the tumour types, and the mechanisms that control the expression of CEA and related antigens in the neoplasms may be similar to those operative in verruca vulgaris.     

Apoptosis Identified by DNA Fragmentation in Epidermal Neoplasms

In the previous study, we demonstrated apoptotic cells in basal cell carcinomas by means of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL). Positive staining cells were present at the peripheries and centers of the nests. The number of positive cells increased in cases showing deep infiltration. We also stained other epidermal neoplasms using this modified TUNEL method. In squamous cell carcinomas, many positive cells were observed in poorly differentiated types, but only a few cells were stained in well-differentiated types. TUNEL positive cells were rare in Bowen's disease. No positive cells were seen in seborrheic keratosis or verruca vulgaris. Our studies showed that apoptotic cells were more common in rapid growth neoplasms than in slow growth neoplasms.     

Smad7在脂溢性角化病、日光性角化病及基底细胞癌中的表达

目的： 检测Smad7在脂溢性角化病、日光性角化病以及基底细胞癌中的表达。方法：对脂溢性角化病、日光性角化病及基底细胞癌标本（各30例）和30例正常标本进行免疫组化染色。结果：23例脂溢性角化病标本、23例日光性角化病标本和28例基底细胞癌标本中Smad7染色阳性,阳性细胞率分别为（31.0±23.0）%,（32.7±26.3）%和（62.6±32.1）%,均显著高于正常组织的（6.7±5.0%）。结论： Samd7可能与脂溢性角化病、日光性角化病以及基底细胞癌的发病有关。     

Trichilemmal tumor arising in a seborrheic keratosis: analysis of cell kinetics by BrdU staining.

We report a case of a 74-year-old male with a trichilemmal tumor arising in a seborrheic keratosis on the buttock and the results of a cell kinetic study of this tumor using a BrdU staining method. The incidence of trichilemmal tumor arising in a seborrheic keratosis seems to be extremely rare. The labeling index of this tumor was 12.0%; this was a level intermediate between normal epidermis and a variety of hyperproliferative skin diseases such as squamous cell carcinoma, Bowen's disease, and psoriasis vulgaris. DNA replicating cells were present in the germinative layers in normal epidermis and the benign hyperproliferative skin diseases, psoriasis vulgaris. In contrast, DNA replicating cells were found throughout the entire epidermis in premalignant and malignant tumors such as in Bowen's disease and squamous cell carcinoma. In this case, DNA replicating cells were localized mainly in the basal and parabasal cell layers, but also seen in the upper squamous layers. These findings suggest that this trichilemmal tumor had a malignant tendency, though it was slow-growing and relatively benign in nature.