皮肤基底细胞癌和鳞状细胞癌皮损中Smad7、Smurf1和Smurf2的表达

目的 探讨Smad7、Smurf1和Smurf2在基底细胞癌和鳞状细胞癌皮损中表达水平的变化及其意义。方法 采用实时定量聚合酶链反应和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Smad7、Smurf1和Smurf2的表达。结果 Smad7、Smurf1和Smurf2在基底细胞癌和鳞状细胞癌中的表达较正常表皮显著升高。结论 基底细胞癌和鳞状细胞癌皮损中Smad7、Smurf1和Smurf2的表达增强可能干扰转化生长因子β（TGFβ）信号转导通路的多个环节，使TGFβ抑制上皮增生的作用不能有效发挥，从而有助于上述表皮肿瘤的异常增殖。     

Photodynamic therapy for superficial basal cell carcinoma and Bowen's disease

Photodynamic therapy (PDT) is an effective treatment for superficial basal cell carcinoma (BCCs) and Bowen's disease. Several studies have reported complete response rates of 80-95% and an excellent cosmetic outcome. Bowen's disease and superficial basal cell carcinomas characteristically affect older patients who may also have associated difficulties with mobility. Using a portable PDT light source we were able to deliver PDT in a community setting with the aim of providing a more convenient service for patients. This randomised study confirmed that community delivered PDT is a viable treatment option and can be administered safely in the community by a trained dermatology nurse. The results from patient questionnaires suggest that community delivered PDT is more convenient to the patient, and also cost effective.     

Methylaminolaevulinate-based photodynamic therapy of Bowen's disease and squamous cell carcinoma

Background  Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) is an approved noninvasive treatment option for actinic keratosis and Bowen's disease (BD), two precursors of invasive squamous cell carcinoma (SCC).
Objectives  To assess efficacy, prognostic features, tolerability and cosmetic outcome of MAL-PDT for the treatment of BD and SCC.
Methods  In total, 112 biopsy-proven lesions of BD and SCC in 55 subjects were treated in an outpatient setting. MAL cream (160 mg g⁻¹) was applied for 3 h prior to illumination with a light-emitting diode source (wavelength range 635 ± 18 nm; light dose 37 J cm⁻²). A second MAL-PDT session was given 7 days later. Complete response rate at 3 months after the last treatment, recurrence rate at the 24-month follow-up, and cosmetic outcome were recorded.
Results  The overall complete response rates were 73·2% at 3 months and 53·6% at 2 years. Clinical thickness, atypia and lesion depth were significant predictors of the response at 3 months when using a univariate analysis ( P  <   0·001). A multivariate logistic regression model, with robust variance estimation, showed that cell atypia was the only statistically significant independent predictor of the treatment outcome at 3 months.
Conclusions  MAL-PDT may represent a valuable, effective and well tolerated treatment option with good cosmetic outcome for superficial, well-differentiated (Broders' scores I and II) BD and microinvasive SCC. In contrast, its use for superficial SCCs with a microinvasive histological pattern and for nodular, invasive lesions, particularly if poorly differentiated keratinocytes are present (Broders' scores III and IV), should be avoided.     

E-钙黏素在鳞癌、Bowen病和脂溢性角化病中的表达

目的: 检测E-钙黏素(E-cadherin)在皮肤鳞状细胞癌(SCC)、Bowen病(BD)、脂溢性角化病(SK)中的表达.方法: 用免疫组化染色方法检测10例正常皮肤,20例SCC、20例BD、20例SK中E-钙黏素的表达.结果: E-钙黏素在SK表皮中的表达与正常表皮相似,在SCC中表达显著减弱或完全无表达,而在Bowen病表皮正常区域表达正常或下调.结论: E-钙黏素在恶性皮肤癌中表达异常,可能与表皮肿瘤的侵袭和转移有关.     

Bowen's disease and squamous cell carcinoma in Haber's syndrome: two cases

BACKGROUND: Haber's syndrome is a rare form of autosomal dominant genodermatosis. Clinically, it is associated with rosaceiform dermatosis of the face that begins in childhood, and profuse keratotic lesions resembling seborrheic keratoses, seen predominantly on the trunk, the tops of the limbs and the scalp. We report two cases of Bowen's disease and cutaneous epidermoid carcinoma in Haber's syndrome patients. OBSERVATIONS: A 67 year-old woman with Haber's syndrome and with a familial history consulted for a budding lesion on the abdomen, histological examination of which confirmed epidermoid carcinoma. A 77 year-old woman presented a clinical picture consistent with Haber's syndrome, with three infiltrated erythematosquamous abdominal lesions. Histological examination of a biopsy sample confirmed the clinical diagnosis of Bowen's disease. The patient was successfully treated with imiquimod. DISCUSSION: These two cases appear to indicate the existence of an association between Haber's syndrome and the presence of cutaneous carcinomatous lesions. We propose the hypothesis of transformation of the keratoses seen in seborrheic keratosis. These lesions may be considered as pre-cancerous. Association with skin carcinomas requires regular monitoring of these patients. The use of imiquimod to treat lesions in patients with Bowen's disease resulted in complete cure.     

p27及skp2在皮肤鳞状细胞癌和Bowen病中的表达

p27是新发现的细胞周期调控因子,S相激酶相关蛋白(skp2)参与p27的降解,我们采用免疫组化方法对皮肤鳞状细胞癌和Bowen病组织中的p27和skp2的表达进行检测.     

SGK1在日光性角化病、基底细胞癌及鳞状细胞癌中的表达

目的：检测SGK1在日光性角化病（AK）、基底细胞癌（BCC）及鳞状细胞癌（SCC）中的表达。方法：采用免疫组化SABC法检测SGK1在25例正常皮肤(NS)、25例AK、28例BCC、28例皮肤鳞状细胞癌标本中的表达。结果：NS、AK、BCC和SCC标本中,SGK1阳性细胞率分别为（40.03±14.42）%,（36.63±14.28）%,（52.82±18.73）%和（52.58±20.13）%。BCC组和SCC组分别与NS组比较,差异均有统计学意义（Ps<0.05）。各组SGK1染色阳性细胞率>50%的标本分别为6例（24%）,3例（12%）,16例（57.14%）和14例（50%）,BCC组和SCC组分别与NS组比较,差异均有统计学意义（Ps<0.05）。结论：SGK1的高表达可能与基底细胞癌及鳞状细胞癌的发病有关。     

多发结节型基底细胞癌并鲍温病1例

报告1例面部多发结节型基底细胞癌并鲍温病患者。患者女,92岁,面部多发黑色结节及褐色斑块,术后病理活检分别提示基底细胞癌(结节型)及鲍温病。本患者多发基底细胞癌及鲍温病,提示临床中对可疑皮疹注意多点取材,避免漏诊。面部多发肿瘤治疗涉及美容需求,本文就其诊断治疗展开讨论。     

Proliferating cell nuclear antigen distribution in keratoacanthoma and squamous cell carcinoma

Histologic differentiation of keratoacanthoma (KA) and squamous cell carcinoma (SCC) is often difficult despite well-delineated histopathologic criteria. This has prompted a search for more objective methods to differentiate these two lesions. In the present study, we immunohistochemically examined the distribution of proliferating cell nuclear antigen (PCNA)-positive cells in 11 cases of KA, 7 cutaneous SCC, and 2 atypical squamous proliferations (for which a definitive diagnosis could not be made on routine histology) using a commercially prepared anti-PCNA monoclonal antibody. We found PCNA-positive cells predominantly in the periphery of squamous nests in KA. In contrast, SCC showed a diffuse staining pattern with PCNA-positive cells seen throughout squamous nests. Determining the pattern of PCNA-positive cells is easy, does not require cell counting, and may provide additional histochemical data facilitating the distinction between KA and SCC.     

Raptor、Rictor和磷酸化Akt在日光性角化病、Bowen病及鳞状细胞癌中的表达

目的:检测Raptor、Rictor和磷酸化Akt(p-Akt)在日光性角化病、Bowen病和鳞状细胞癌中的表达。方法:采用免疫组化法检测Raptor、Rictor及p-Akt(Ser473)在20例正常皮肤、20例日光性角化病、20例Bowen病及40例鳞状细胞癌中的表达。结果:Raptor在鳞状细胞癌、Bowen病和日光性角化病中的阳性表达率分别为87.50%、70.00%和60.00%,均高于正常皮肤的25.00%(均P0.05);其中低分化鳞状细胞癌中Raptor的阳性表达率为100%,高于高分化鳞状细胞癌的阳性表达率75%(P0.05)。Rictor在鳞状细胞癌、Bowen病和日光性角化病中的阳性表达率分别为80.00%、70.00%及55.00%,均高于正常皮肤阳性表达率的20%(均P0.05);p-Akt(Ser473)在鳞状细胞癌、Bowen病和日光性角化病中的阳性表达率分别为77.50%、65.00%及50.00%,而正常皮肤阳性表达率为0。鳞状细胞癌、Bowen病和日光性角化病中Rictor的阳性表达水平和p-Akt(Ser473)的阳性表达水平均呈正相关(均P0.05)。结论:Raptor、Rictor和p-Akt(Ser473)的高表达可能与日光性角化病、Bowen病和鳞状细胞癌的发生发展有关。     

银屑病素在光线性角化病、Bowen病及皮肤鳞状细胞癌组织中的表达及意义

目的 研究银屑病素在光线性角化病、Bowen病及皮肤鳞状细胞癌(鳞癌)中的表达.方法 用免疫组化的方法检测18例正常皮肤组织、20例光线性角化病、25例Bowen病、21例高分化皮肤鳞癌及16例低分化鳞癌皮损中银屑病素的表达.结果 银屑病素在正常皮肤组织中表达阳性率为11.1％.在光线性角化病中19例银屑病素表达于角质层至棘层上1～3层,胞质着色,阳性率为95.0％.在Bowen病中22例银屑病素表达于表皮全层角质形成细胞,胞质着色,空泡状细胞包膜及胞质着色,阳性率为88％.在高分化鳞癌中20例银屑病素表达于角质层至棘层全层,角化珠及角化不良细胞着色,阳性率为95.2％;在低分化鳞癌中13例银屑病素表达于角质层至棘层上1～5层,低分化的鳞状细胞不着色,阳性率为92.3％.与正常皮肤组相比,银屑病素在光线性角化病、Bowen病、高分化鳞癌和低分化鳞癌中的表达差异均有统计学意义(P＜0.01).银屑病素在光线性角化病、Bowen病、高分化鳞癌中表达强度逐渐升高,而在低分化鳞癌中表达强度降低,但仍高于正常皮肤组织(P＜0.05).结论 银屑病素在鳞状细胞分化异常的皮肤病中表达异常.     

High level of serum squamous cell carcinoma-related antigen in a case of Bowen's disease

A case of Bowen's disease on the lower abdomen is described. It was characterized by the unusually large size of the lesion and the high level of serum squamous cell carcinoma-related antigen which, however, decreased rapidly after surgical removal of the tumor.     

Tight junction-associated proteins (occludin, ZO-1, claudin-1, claudin-4) in squamous cell carcinoma and Bowen's disease

BACKGROUND: The epidermis, which is a typical stratified epithelium, has tight junctions (TJs) in the granular layer, as do simple epithelia. So far, abnormalities of TJs and involvement of claudin-1 have been reported in tumours of simple epithelia. OBJECTIVES: To examine the expression of TJ-associated proteins (occludin, ZO-1, claudin-1 and claudin-4) in normal human epidermis and in malignant disorders of keratinization. METHODS: Expression of the proteins in normal human epidermis, five cases of squamous cell carcinoma (SCC) of the skin and five cases of Bowen's disease (BD) was examined by immunofluorescence staining. RESULTS: In normal human epidermis, occludin, ZO-1 and claudin-4 were expressed at the cell-cell borders in the granular layer specifically or dominantly, whereas claudin-1 was expressed in the whole epithelium. In SCC, occludin, ZO-1, claudin-1 and claudin-4 were strongly expressed in tumour cells with keratinization such as cancer pearls. Claudin-1 was heterogeneously expressed in unkeratinized tumour cells, whereas expression of occludin, ZO-1 and claudin-4 was decreased or absent. In BD, aberrant expression of occludin, ZO-1, claudin-1 and claudin-4 was observed at the cell-cell borders in addition to their expression patterns observed in normal epidermis. CONCLUSIONS: Expression of occludin, ZO-1 and claudin-4 is associated with keratinization in SCC and BD. However, the heterogeneous expression of claudin-1 in SCC is not determined only by keratinization.     

Fascin-1蛋白在基底细胞癌及鳞状细胞癌中的表达

目的 探讨fascin-1蛋白与基底细胞癌及鳞状细胞癌局部侵袭的相关性。方法 免疫组化方法对10例正常皮肤组织、13例皮肤基底细胞癌（8例结节型、5例浅表型）、24例皮肤鳞状细胞癌（11例原位鳞状细胞癌,13例侵袭性鳞状细胞癌均无转移）进行fascin-1染色,计算机图像分析系统进行观察及定量分析。结果 Fascin-1蛋白在原位鳞状细胞癌（平均光密度0.1152 ± 0.04574）、侵袭性鳞状细胞癌（平均光密度0.1257 ± 0.03096）中的表达明显高于正常上皮组织（平均光密度0.0293 ± 0.00981,P ＜ 0.05）。在结节型基底细胞癌（平均光密度0.0808 ± 0.05642）、浅表型基底细胞癌（平均光密度0.0806 ± 0.04346）中表达差异无统计学意义,但明显高于正常上皮组织（平均光密度0.0293 ± 0.00981,P ＜ 0.05）。结论 在基底细胞癌及鳞状细胞癌中,fascin-1蛋白表达上调可能与肿瘤的局部侵袭相关。     

Immunohistochemical characterization of cellular infiltrates in squamous cell carcinoma and Bowen's disease occurring in one patient.

We investigated populations of the infiltrating cells in Bowen's disease (BD) and squamous cell carcinoma (SCC), both of which arose in the same patient, using the Avidin-Biotin-peroxidase complex method with eight monoclonal antibodies. T lymphocytes were most predominant among infiltrating cells; NK cells, B cells, and monocytes were rarely seen in either BD or SCC. Analysis of subsets of the infiltrating T lymphocytes revealed that the number of suppressor/cytotoxic (s/c) T cells was twice that of helper/inducer (h/i) T cells in BD, while the number of s/c T cells was lower than that of h/i T cells in SCC. The immunohistochemical results in the present case differed from those of predominant infiltration of h/i T cells and of s/c T cells in three other reports of BD and SCC. These results suggest that the population of the cellular infiltrates may be modulated by the nature of tumors and by the immuno-competent state of the hosts.