Berner Aasmund
Fagområde patologi, Det norske radiumhospital, 0310 Oslo.
Tidsskr Nor Laegeforen. 2005 Jun 16;125(12):1653-4.
Actinic keratosis is a common sun-induced skin disease. For many years there has been a great deal of discussion of the term used for the disease and of its classification. Recent molecular studies indicate an association between actinic keratosis and squamous cell carcinoma.
Review of recent reports on histological, molecular, biochemical and clinical findings in actinic keratosis and cutaneous squamous cell carcinoma.
The morphology of atypical cells in both actinic keratosis and squamous cell carcinoma is identical. The risk of progression to squamous cell carcinoma is minimal, but up to 60% of squamous cell carcinoma cases begin as actinic keratosis. Regression of actinic keratosis occurs when sun exposure is decreased. Examination of possible chromosome aberrations and gene mutations in both actinic keratosis and squamous cell carcinoma reveals similar patterns, including the same mutation in the tumour suppressor gene TP53. Recent studies indicate that actinic keratosis is the earliest manifestation of a potentially malignant disease similar to carcinoma in situ in cervix uteri. Thus, actinic keratosis requires careful diagnosis and follow up.
光化性角化病是一种常见的日光诱导性皮肤病。多年来,对于该疾病的命名及其分类一直存在大量讨论。近期的分子研究表明光化性角化病与鳞状细胞癌之间存在关联。
回顾近期关于光化性角化病和皮肤鳞状细胞癌的组织学、分子、生化及临床研究结果的报告。
光化性角化病和鳞状细胞癌中不典型细胞的形态相同。进展为鳞状细胞癌的风险极小,但高达60%的鳞状细胞癌病例起始于光化性角化病。当日照减少时光化性角化病会消退。对光化性角化病和鳞状细胞癌中可能存在的染色体畸变和基因突变的检测揭示了相似的模式,包括肿瘤抑制基因TP53中的相同突变。近期研究表明,光化性角化病是一种潜在恶性疾病的最早表现,类似于子宫颈原位癌。因此,光化性角化病需要仔细诊断和随访。