c-kit蛋白在恶性黑素瘤中的表达

目的　探讨c kit蛋白在人恶性黑素瘤中的表达及临床意义 ,分析它和临床病理参数的关系。方法　采用免疫组化S P法检测 44例原发性皮肤恶性黑素瘤、9例转移性恶性黑素瘤及 2 0例良性痣中c kit蛋白的表达。结果　3 4例原发性皮肤恶性黑素瘤、4例转移性恶性黑素瘤、5例良性痣表达c kit蛋白 ,阳性率分别为 77.3 %、44 .4%、2 5 .0 % ,前者的阳性表达率显著高于后两者 (P均 <0 .0 5 ) ;原发性皮肤恶性黑素瘤中浅表扩散性恶性黑素瘤 (SSM )的c kit蛋白阳性表达率显著高于其它类型 (P均 <0 .0 1) ;c kit蛋白的表达与年龄 性别 发病部位 是否淋巴结转移等临床病理因素均无关 (P均 >0 .0 5 )。结论　c kit蛋白的表达可能与人恶性黑素瘤的发生发展有关 ,其有望成为治疗黑素瘤的有效靶向分子之一     

胰岛素样生长因子ⅡmRNA结合蛋白3在恶性黑素瘤及良性痣中的表达

目的 探讨胰岛素样生长因子Ⅱ mRNA结合蛋白3(IMP3)在良性痣及黑素瘤组织中的表达,及其在恶性黑素瘤进展及诊断中的作用.方法 用IMP3抗体对28例恶性黑素瘤、8例Spitz痣、6例发育不良性痣和25例良性痣患者的标本组织进行免疫组化研究.结果 28例恶性黑素瘤组织标本中23例IMP3阳性,8例Spitz痣中4例阳性,6例发育不良性痣中2例阳性,25例良性痣均不表达.IMP3在黑素瘤中的表达明显高于Spitz痣及发育不良性痣(P<0.05),侵袭性黑素瘤表达明显高于原位黑素瘤(P<0.01).结论 IMP3可能是良性痣发展至恶性黑素瘤的一个生物学标志,在鉴别黑素瘤和良性痣之间存在一定的价值.     

恶性黑素瘤的端粒酶活性研究

目的检测恶性黑素瘤标本中的端粒酶活性,探讨端粒酶在黑素瘤发生机制中的作用。方法采用聚合酶链反应-酶联免疫吸附测定法(PCR-ELISA),对黑素瘤标本进行端粒酶的定性和定量分析。结果90.0％的原发性黑素瘤和100％的转移性黑素瘤显示端粒酶阳性,仅14.3％的黑素细胞痣呈阳性,而正常皮肤中均为阴性。转移性黑素瘤、原发性黑素瘤、黑素细胞痣和正常皮肤的端粒酶活性水平的平均A值分别为0.729、0.405、0.118和0.044。各组端粒酶活性A值之间经统计学分析差异有显著性。结论大部分恶性黑素瘤患者中存在高水平的端粒酶活性,提示端粒酶可能在黑素瘤的发生机制中起重要作用,对黑素瘤的诊断有一定的临床意义。     

基质金属蛋白酶7在恶性黑素瘤中的表达

目的 探讨基质金属蛋白酶7（MMP7）的表达与恶性黑素瘤浸润、转移的关系。方法 采用免疫组化SP法研究MMP7在恶性黑素瘤（30例）、交界痣（30例）、正常人皮肤（15例）组织中的表达，并观察其在恶性黑素瘤A375细胞株和不同浓度乙酰肝素酶反义寡核苷酸转染的裸鼠体内恶性黑素瘤移植瘤中的表达情况。结果 MMP7在恶性黑素瘤组、交界痣组及正常人皮肤组中的阳性表达率分别为83.33%（25/30）、6.67%（2/30）和0，恶性黑素瘤组与交界痣组MMP7的阳性表达率比较，χ2 = 35.62，P < 0.01；交界痣组与正常人皮肤组比较，差异无统计学意义。10、20、30 μmol/L乙酰肝素酶反义寡核苷酸对裸鼠体内恶性黑素瘤移植瘤MMP7表达表现出不同程度的抑制作用，30 μmol/L组的抑制作用最强，与其他2个组相比，差异均有统计学意义（P < 0.05）。MMP7在A375细胞株中呈强阳性表达。结论 MMP7在恶性黑素瘤中的表达明显高于其在交界痣和正常人皮肤；乙酰肝素酶反义寡核苷酸对裸鼠体内恶性黑素瘤移植瘤中MMP7的表达有显著抑制效应；MMP7在A375细胞株中呈强阳性表达。     

磷酸化活化转录因子2和磷酸化细胞信号传导与转录活化因子3在皮肤恶性黑素瘤中的表达

目的:探讨磷酸化活化转录因子(p-ATF)2和磷酸化细胞信号传导与转录活化因子(p-STAT)3在皮肤恶性黑素瘤中的表达及其临床意义.方法:采用免疫组化方法分别检测p-ATF2 和p-STAT3 在25 例原发性皮肤恶性黑素瘤(CMM)患者和14例转移性恶性黑素瘤(转移性MM)患者组织病理切片中的表达水平.结果:p-ATF2和p-STAT3在25例CMM和14例转移性MM 患者组织病理切片中细胞表达阳性率均分别显著高于色素痣中的表达阳性率(P ＜ 0.01),但在25 例CMM 和14 例转移性MM之间细胞表达阳性率差异无统计学意义(P ＞ 0.05).在25例CMM和14例转移性MM 患者组织病理切片中,p-ATF2阳性表达与p-STAT3阳性表达均分别有高度相关性(r分别为0.912和0.934,P 均＜0.01).结论:p-ATF2 和p-STAT3 虽在CMM 和转移性MM 中高表达,但与皮肤恶性黑素瘤的侵袭和转移无明显相关.     

钠氢交换子调节因子-1及β-联蛋白在皮肤黑素瘤及痣细胞痣组织中的表达

目的 探讨皮肤黑素瘤及痣细胞痣组织中钠氢交换子调节因子-1 (NHERF1)和β-联蛋白表达的意义.方法 收集47例皮肤黑素瘤及37例痣细胞痣组织,用免疫组化方法对NHERF1和β-联蛋白在组织中的表达模式(膜表达、浆表达及核表达)和表达强度进行检测.结果 原位皮肤黑素瘤组织中NHERF1胞质中等/强阳性表达率为38％;而侵袭性皮肤黑素瘤组织中NHERF1胞质中等/强阳性表达率为71％,两组相比差异有统计学意义.同时,全部皮肤黑素瘤组织中NHERF1胞质中等/强阳性表达率为60％,而痣细胞痣组织中NHERF1胞质中等/强阳性表达率为0,差异有统计学意义.原位皮肤黑素瘤组织中可见β-联蛋白胞质中等/强阳性表达率为50％;而侵袭性皮肤黑素瘤组织中可见β-联蛋白胞质中等/强阳性表达率为84％.两组相比差异有统计学意义.全部皮肤黑素瘤组织中B一联蛋白胞质中等/强阳性表达率为72％,而痣细胞痣组织中NHERF1胞质中等/强阳性表达率为30％,两组相比具异有统计学意义.NHERF1及β-联蛋白胞质中等/强阳性表达率在痣细胞痣组、原位黑素瘤组及侵袭性黑素瘤组中均随着病变组织的恶性程度增加而升高.运用Spearman秩相关检验对皮肤黑素瘤中NHERF1及β-联蛋白的表达相关性进行分析显示无相关性.结论 NHERF1及β-联蛋白在痣细胞痣、原位黑素瘤及侵袭性黑素瘤组织中的胞质阳性表达随着病变组织的恶性程度增加而升高,但两者的表达差异无相关性.     

少见病理类型的恶性黑素瘤

恶性黑素瘤是一种高度恶性的肿瘤,多发生于皮肤。根据恶性黑素瘤的临床及病理特点,通常将恶性黑素瘤分为原位恶性黑素瘤(malignant melanoma insitu)和侵袭性恶性黑素瘤(invasive malignant melanoma)。原位恶性黑素瘤又分3型,分别为恶性雀斑样痣(lentigo maligna)、浅表扩散性原位恶性黑素瘤(superficial spreading malignant melanoma)及肢端原位恶性黑素瘤(acral melanoma in situ)。     

IGFBP7在皮肤黑素瘤组织和细胞系中的表达

目的:检测胰岛素样生长因子结合蛋白7(IGFBP7)在皮肤黑素瘤组织和细胞系中的表达。方法:免疫组化法检测25例原发性皮肤黑素瘤、5例转移性皮肤黑素瘤、20例良性色素痣、10例正常皮肤组织和4株人黑素瘤细胞系中IGFBP7的表达。结果:IGFBP7在正常皮肤和良性色素痣细胞浆中的阳性表达率为85%,而在皮肤黑素瘤胞浆中的阳性表达率为16%和20%。除人黑素瘤细胞系MV3阳性表达IGFBP7外,其余细胞系均阴性表达。结论:IGFBP7在皮肤黑素瘤组织和细胞系中的低表达或功能缺失可能参与了皮肤黑素瘤的发病。     

人类单克隆抗体在固定组织切片上鉴别皮肤恶性黑素瘤和良性痣

本文作者用转移性黑素瘤患者局部淋巴结的淋巴细胞与小鼠骨髓瘤细胞株M5融合获得了6株稳定的杂交瘤,从中选出二株IgG单克隆抗体,采用直接卵蛋白—生物素—免疫过氧化酶染色方法研究了64个福尔马林固定,石腊包埋的组织切片.结果二株抗体均与所有18例原发性皮肤恶性黑素瘤、5例转移性皮肤黑素瘤及2例眼黑素瘤有阳性染色反应.其中一株抗体(2-139-1)能与4份恶性雀斑样痣标     

乙酰肝素酶mRNA和蛋白在恶性黑素瘤皮损及A375细胞株中的表达

目的探讨乙酰肝素酶mRNA和蛋白在恶性黑素瘤皮损及A375细胞株中的表达及意义。方法选择恶性黑素瘤30例、黑素细胞痣30例、恶性黑素瘤A375细胞株及15例正常皮肤组织,分别采用原位杂交、免疫组化法检测皮损及细胞株中乙酰肝素酶mRNA及蛋白的表达。结果A375细胞株及19例(19/30,63.33%)恶性黑素瘤皮损中乙酰肝素酶mRNA呈阳性表达,2例(2/30,6.67%)黑素细胞痣皮损中乙酰肝素酶mRNA表达阳性,正常皮肤组织中无1例呈阳性表达;恶性黑素瘤皮损中乙酰肝素酶蛋白的阳性表达率与黑素细胞痣、与正常对照组相比,差异均有显著性意义(χ12=19.200,P=0.000;χ22=25.714,P=0.000)。乙酰肝素酶蛋白在恶性黑素瘤、恶性黑素瘤A375细胞株、黑素细胞痣及正常皮肤组织的表达情况与mRNA相一致。结论乙酰肝素酶mRNA和蛋白的高表达可能与恶性黑素瘤的发生发展有关,有望作为治疗黑素瘤的靶点。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.