Wilgenbus K, Lentner A, Kuckelkorn R, Handt S, Mittermayer C
Institut für Pathologie, Rheinisch Westfälisch Technische Hochschule Aachen, Federal Republic of Germany.
Arch Dermatol Res. 1992;284(5):266-70. doi: 10.1007/BF00372579.
The pathogenesis of cutaneous paraneoplastic syndromes is still under discussion. Since many of these syndromes, including acanthosis nigricans, are proliferative skin disorders it is believed that products secreted by the tumour stimulate the keratinocytes to proliferate. Growth factors like transforming growth factor alpha (TGF-alpha) are known to be highly mitogenic for keratinocytes in vitro. Here we report on a patient with a poorly differentiated gastric cancer and a full clinical picture of acanthosis nigricans characterized by diffuse hyperkeratosis and multiple papillomatous lesions of the skin with involvement of the conjunctivae. In Southern blot analysis of the tumour tissue from this patient amplification of the epidermal growth factor (EGF) receptor, the common ligand for TGF-alpha and EGF, was shown. Immunohistochemically, prominent staining was found throughout the tumour using anti-TGF-alpha antibodies. In a series of 25 investigated gastric tumour biopsies, four tumours showed amplification of the EGF receptor and one additional biopsy was positive for TGF-alpha. Since there is no other report describing the link between TGF-alpha and acanthosis nigricans, except that of Ellis et al. 1987, we present a new case suggesting a possible link between growth factors and acanthosis nigricans maligna.
皮肤副肿瘤综合征的发病机制仍在探讨之中。由于其中许多综合征，包括黑棘皮病，都是增殖性皮肤疾病，因此人们认为肿瘤分泌的产物会刺激角质形成细胞增殖。已知诸如转化生长因子α（TGF-α）等生长因子在体外对角质形成细胞具有高度促有丝分裂作用。在此，我们报告一名患有低分化胃癌且伴有典型黑棘皮病临床表现的患者，其特征为弥漫性角化过度以及累及结膜的皮肤多发性乳头瘤样病变。在对该患者肿瘤组织进行的Southern印迹分析中，显示出表皮生长因子（EGF）受体（TGF-α和EGF的共同配体）的扩增。免疫组织化学分析显示，使用抗TGF-α抗体在整个肿瘤中均发现明显染色。在对25例接受研究的胃肿瘤活检组织中，有4例肿瘤显示EGF受体扩增，另有1例活检组织TGF-α呈阳性。除了埃利斯等人1987年的报告外，尚无其他报告描述TGF-α与黑棘皮病之间的联系，因此我们呈现这一新病例，提示生长因子与恶性黑棘皮病之间可能存在联系。
