CK15及CK19在表皮及皮肤附属器肿瘤中的表达及其诊断价值

目的:检测表皮干细胞标记物细胞角蛋白15（CK15）及细胞角蛋白19（CK19）在表皮肿瘤及皮肤附属器肿瘤中的表达强度。方法:选择155例东营市人民医院病理科确诊的皮肤肿瘤，进行免疫组织化学检测，观察并记录CK15和CK19的表达强度。结果:155例皮肤肿瘤组织中CK15和CK19的表达强度不同。CK15毛分化肿瘤均显示阳性表达，而且外毛根鞘瘤/癌与鳞状细胞癌的表达有统计学差异（P＜0.05），毛母细胞瘤与组织形态学相近的基底细胞癌、汗孔瘤的表达有统计学差异（P＜0.05）。CK19在鳞状细胞癌、外毛根鞘瘤、外毛根鞘癌中几乎不表达，鳞状细胞癌与基底细胞癌、汗腺来源肿瘤及毛发上皮来源肿瘤均存在统计学差异（P＜0.05）。结论:免疫组织化学检测CK15、CK19的表达强度可以用来诊断及鉴别诊断组织学形态相近的皮肤肿瘤。

The expression and diagnostic value of CK15 and CK19 in epidermal and skin adnexal tumors

Objective:To detect the expression levels of epidermal stem cell markers CK15 and CK19 in epidermal tumors and skin appendage tumors.Methods:A total of 155 cases of skin tumors confirmed by the Pathology Department of Dongying People's Hospital were selected for immunohistochemical detection,and the expression levels of cytokeratins 15 and 19 were observed and recorded.Results:The expression levels of CK15 and CK19 were different in 155 skin tumors.Hair differentiated tumors showed positive expression of CK15,and the expression of tricholemmoma/tricholemmal carcinoma was significantly different from that of squamous cell carcinomas（P＜0.05).There were significant differences in the expression between trichoblastoma and similar histomorphology skin tumors,such as basal cell carcinoma and poroma（P＜0.05).CK19 was almost not expressed in squamous cell carcinoma,tricholemmoma/tricholemmal carcinoma,and was significantly different from basal cell carcinoma,sweat gland-derived tumor and hair follicle tumor（P＜0.05).Conclusion:The expression levels of CK15 and CK19 detected by immunohistochemistry can be used for the diagnosis and differential diagnosis of skin tumors with similar histomorphology.