Альманах клинической медицины. 2016; 44: 58-63
ОСОБЕННОСТИ ПРОЛИФЕРАЦИИ И МЕЖКЛЕТОЧНОЙ АДГЕЗИИ В ПРЕДРАКОВЫХ И ЗЛОКАЧЕСТВЕННЫХ ЭПИТЕЛИАЛЬНЫХ ОПУХОЛЯХ КОЖИ
https://doi.org/10.18786/2072-0505-2016-44-1-58-63Аннотация
Актуальность. Дифференциальная диагностика актинического кератоза, относящегося к предраковым заболеваниям кожи, и внутриэпидермального плоскоклеточного рака кожи, или болезни Боуэна, представляет в ряде случаев определенные трудности даже при проведении морфологического исследования. Изучение молекулярных особенностей предраковых состояний кожи позволит проводить более точную диагностику и оценку прогноза заболевания. Цель – изучение пролиферативной активности кератиноцитов и экспрессии Е-кадгерина на мембранах клеток при актиническом кератозе и болезни Боуэна, определение дифференциально-диагностических критериев. Материал и методы. Проведено иммуногистохимическое исследование с моноклональными антителами к Ki-67 и Е-кадгерину биопсийного материала пораженной кожи 23 больных актиническим кератозом и 10 пациентов с болезнью Боуэна. Результаты. При актиническом кератозе без очагов боуэнизации средний индекс пролиферации составил 30,9 ± 11,4% (от 11,5 до 48,4%); при актиническом кератозе с очагами боуэнизации – 40,3 ± 8,6% (от 31 до 57,6%). При этом в обеих подгруппах экспрессия Е-кадгерина во всех случаях (100%) носила мембранный характер. При болезни Боуэна средний индекс пролиферации составил 44,7 ± 8,2% (от 33,3 до 60%). В 48,2% клеток болезни Боуэна отмечали аномальные типы экспрессии Е-кадгерина (мембранно-редуцированный, мембранно-цитоплазматический, цитоплазматический). Заключение. Актинический кератоз и болезнь Боуэна представляют собой разные стадии развития одного и того же злокачественного процесса, отличающиеся по пролиферативной активности клеток и экспрессии Е-кадгерина, которые можно использовать в качестве дифференциально-диагностических маркеров.
Список литературы
1. Marks R. The epidemiology of non-melanoma skin cancer: who, why and what can we do about it. J Dermatol. 1995;22(11):853–7.
2. Housman TS, Feldman SR, Williford PM, Fleischer AB Jr, Goldman ND, Acostamadie-do JM, Chen GJ. Skin cancer is among the most costly of all cancers to treat for the Medicare population. J Am Acad Dermatol. 2003;48(3):425–9.
3. Marks R, Foley P, Goodman G, Hage BH, Sel-wood TS. Spontaneous remission of solar keratoses: the case for conservative management. Br J Dermatol. 1986;115(6):649–55.
4. Marks R, Rennie G, Selwood TS. Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet. 1988;1(8589):795–7.
5. Dodson JM, DeSpain J, Hewett JE, Clark DP. Malignant potential of actinic keratoses and the controversy over treatment. A patient-oriented perspective. Arch Dermatol. 1991;127(7):1029–31.
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8. Cockerell CJ, Wharton JR. New histopathological classification of actinic keratosis (incipient intraepidermal squamous cell carcinoma). J Drugs Dermatol. 2005;4(4):462–7.
9. Elder DE, Elenitsas R, Johnson BL Jr, Murphy GF, eds. Lever's Histopathology of the Skin. 9th Edition. Philadelphia: Lippincott Williams & Wilkins; 2005. 645 p.
10. Bagazgoitia L, Cuevas J, Juarranz A. Expression of p53 and p16 in actinic keratosis, bowenoid actinic keratosis and Bowen's disease. J Eur Acad Dermatol Venereol. 2010;24(2):228–30. doi: 10.1111/j.1468-3083.2009.03337.x.
11. Hashimoto K, Mehregan AH. Tumors of the epidermis. Stoneham: Butterworth; 1990.
12. Ishida H, Kumakiri M, Ueda K, Lao LM, Yanagihara M, Asamoto K, Imamura Y, Noriki S, Fukuda M. Comparative histochemical study of Bowen's disease and actinic keratosis: preserved normal basal cells in Bowen's disease. Eur J Histochem. 2001;45(2):177–90.
13. Carpenter PM, Linden KG, McLaren CE, Li KT, Arain S, Barr RJ, Hite P, Sun JD, Meyskens FL Jr. Nuclear morphometry and molecular bio-markers of actinic keratosis, sun-damaged, and nonexposed skin. Cancer Epidemiol Bio-markers Prev. 2004;13(12):1996–2002.
14. Tilli CM, Ramaekers FC, Broers JL, Hutchison CJ, Neumann HA. Lamin expression in normal human skin, actinic keratosis, squamous cell carcinoma and basal cell carcinoma. Br J Dermatol. 2003;148(1):102–9.
15. Talghini S, Halimi M, Baybordi H. Expression of p 27, Ki 67, p 53 in squamous cell carcinoma, actinic keratosis and Bowen disease. Pakistan Journal of Biological Sciences. 2009;12(12):929–33. doi: 10.3923/ pjbs.2009.929.933.
16. Lyakhovitsky A, Barzilai A, Fogel M, Trau H, Huszar M. Expression of e-cadherin and beta-catenin in cutaneous squamous cell carcinoma and its precursors. Am J Dermatopathol. 2004;26(5):372–8.
17. Papadavid E, Pignatelli M, Zakynthinos S, Krausz T, Chu AC. Abnormal immunoreactivity of the E-cadherin/catenin (alpha-, beta-, and gamma-) complex in premalignant and malignant non-melanocytic skin tumours. J Pathol. 2002;196(2):154–62.
18. Fuller LC, Allen MH, Montesu M, Barker JN, Macdonald DM. Expression of E-cadherin in human epidermal non-melanoma cutaneous tumours. Br J Dermatol. 1996;134(1):28–32.
Almanac of Clinical Medicine. 2016; 44: 58-63
CHARACTERISTICS OF PROLIFERATION AND INTERCELLULAR ADHESION IN PRE-CANCEROUS AND MALIGNANT EPITHELIAL SKIN TUMORS
https://doi.org/10.18786/2072-0505-2016-44-1-58-63Abstract
Background: Differential diagnostics between actinic keratosis which is one of pre-cancerous skin diseases, and intra-epidermal squamous cell skin cancer (or Bowen's disease) could be difficult in some cases even with morphological examination. The study on molecular characteristics of pre-cancerous skin disorders would allow for more accurate diagnostics and assessment of prognosis. Aim: To study proliferative activity of keratinocytes and E-cadherin expression on cell membranes in actinic keratosis and in Bowen's disease, with identification of differential diagnostic criteria. Materials and methods: We performed an immunohistochemistry study with anti-Ki-67 and anti-Е-cadherin monoclonal antibodies in skin bioptates of 23 patients with actinic keratosis and 10 patients with Bowen's disease. Results: The mean proliferation index in actinic keratosis without the bowen-like loci was 30.9 ± 11.4% (range, from 11.5 to 48.4%), and in actinic keratosis with the bowen-like loci, 40.3 ± 8.6% (range, from 31 to 57.6%). In both groups, E-cadherin expression in all cases (100%) was located in cell membranes. The mean proliferation index in Bowen's disease was 44.7 ± 8.2% (range, from 33.3 to 60%). In 48.2% of Bowen cells, abnormal type of E-cadherin expression (reduced membranous, membranous and cytoplasmatic and cytoplasmatic only). Conclusion: Actinic keratosis and Bowen's disease represent different stages of one and the same malignant process that have different proliferative cell activity and E-cadherin expression, which could be used as differential diagnostic markers.
References
1. Marks R. The epidemiology of non-melanoma skin cancer: who, why and what can we do about it. J Dermatol. 1995;22(11):853–7.
2. Housman TS, Feldman SR, Williford PM, Fleischer AB Jr, Goldman ND, Acostamadie-do JM, Chen GJ. Skin cancer is among the most costly of all cancers to treat for the Medicare population. J Am Acad Dermatol. 2003;48(3):425–9.
3. Marks R, Foley P, Goodman G, Hage BH, Sel-wood TS. Spontaneous remission of solar keratoses: the case for conservative management. Br J Dermatol. 1986;115(6):649–55.
4. Marks R, Rennie G, Selwood TS. Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet. 1988;1(8589):795–7.
5. Dodson JM, DeSpain J, Hewett JE, Clark DP. Malignant potential of actinic keratoses and the controversy over treatment. A patient-oriented perspective. Arch Dermatol. 1991;127(7):1029–31.
6. McCabe M, Nowak M, Maguire D, Robert-son P. Immunosuppression by human skin cancers. Aust J Exp Biol Med Sci. 1984;62 (Pt 5):539–45.
7. Molochkov VA. Ploskokletochnyi rak kozhi. Vestnik dermatologii i venerologii. 1997;(6):44–8.
8. Cockerell CJ, Wharton JR. New histopathological classification of actinic keratosis (incipient intraepidermal squamous cell carcinoma). J Drugs Dermatol. 2005;4(4):462–7.
9. Elder DE, Elenitsas R, Johnson BL Jr, Murphy GF, eds. Lever's Histopathology of the Skin. 9th Edition. Philadelphia: Lippincott Williams & Wilkins; 2005. 645 p.
10. Bagazgoitia L, Cuevas J, Juarranz A. Expression of p53 and p16 in actinic keratosis, bowenoid actinic keratosis and Bowen's disease. J Eur Acad Dermatol Venereol. 2010;24(2):228–30. doi: 10.1111/j.1468-3083.2009.03337.x.
11. Hashimoto K, Mehregan AH. Tumors of the epidermis. Stoneham: Butterworth; 1990.
12. Ishida H, Kumakiri M, Ueda K, Lao LM, Yanagihara M, Asamoto K, Imamura Y, Noriki S, Fukuda M. Comparative histochemical study of Bowen's disease and actinic keratosis: preserved normal basal cells in Bowen's disease. Eur J Histochem. 2001;45(2):177–90.
13. Carpenter PM, Linden KG, McLaren CE, Li KT, Arain S, Barr RJ, Hite P, Sun JD, Meyskens FL Jr. Nuclear morphometry and molecular bio-markers of actinic keratosis, sun-damaged, and nonexposed skin. Cancer Epidemiol Bio-markers Prev. 2004;13(12):1996–2002.
14. Tilli CM, Ramaekers FC, Broers JL, Hutchison CJ, Neumann HA. Lamin expression in normal human skin, actinic keratosis, squamous cell carcinoma and basal cell carcinoma. Br J Dermatol. 2003;148(1):102–9.
15. Talghini S, Halimi M, Baybordi H. Expression of p 27, Ki 67, p 53 in squamous cell carcinoma, actinic keratosis and Bowen disease. Pakistan Journal of Biological Sciences. 2009;12(12):929–33. doi: 10.3923/ pjbs.2009.929.933.
16. Lyakhovitsky A, Barzilai A, Fogel M, Trau H, Huszar M. Expression of e-cadherin and beta-catenin in cutaneous squamous cell carcinoma and its precursors. Am J Dermatopathol. 2004;26(5):372–8.
17. Papadavid E, Pignatelli M, Zakynthinos S, Krausz T, Chu AC. Abnormal immunoreactivity of the E-cadherin/catenin (alpha-, beta-, and gamma-) complex in premalignant and malignant non-melanocytic skin tumours. J Pathol. 2002;196(2):154–62.
18. Fuller LC, Allen MH, Montesu M, Barker JN, Macdonald DM. Expression of E-cadherin in human epidermal non-melanoma cutaneous tumours. Br J Dermatol. 1996;134(1):28–32.
