피부의 기저세포암종과 편평상피세포암종의 감별진단에서 desmoglein1, desmoglein3, epithelial membrane antigen, Ber-EP4 및 CD10 면역조직화학염색의 유용성

Abstract

Distinction between basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) has important clinical implications, since SCC has a notably poor clinical course. However, the distinction between BCC and SCC can be challenging. An appropriate immunohistochemical panel may help to differentiate these lesions. Archived paraffin-embedded tissue samples of cutaneous BCCs (n = 51) and SCCs (n = 40) were stained immunohistochemically using monoclonal antibodies for desmoglein1 (dsg1), desmoglein3 (dsg3), epithelial membrane antigen (EMA), Ber-EP4, and CD10. Ber-EP4 and CD10 were more commonly expressed in BCC (100%, 70.6%) than SCC (7.5%, 30%). In contrast, dsg1, dsg3, and EMA were more commonly expressed in SCC (70%, 95%, and 87.5%) than BCC (0%, 17.7%, and 0%). Especially, more than 50% of tumor cells expressed Ber-EP4 in 96.7% of BCCs but only in 7.5% of SCCs. Also, more than 50% of tumor cells expressed dsg3 and EMA in 82.5% and 62.5% of SCCs but only in 2% and 0% of BCCs, respectively. All differences were statistically significant. In summary, immunohistochemical stain for dsg1, dsg3, EMA, Ber-EP4 and CD10 may help in distinction of BCC from SCC. A Ber-EP4 positive, dsg3 and/or EMA negative immunophenotype supports BCC. In contrast, Ber-EP4 negative, dsg3 and/or EMA positive immunophenotype supports SCC in limited specimen such as punch biopsied skin.

Keywords: desmoglein, skin, basal cell carcinoma, squamous cell carcinoma, immunohistochemistry