Department of Dermatology and Skin Cancer, Roger Williams Medical Center, Providence, Rhode Island 02908, USA.
Dermatol Surg. 2012 Aug;38(8):1357-66. doi: 10.1111/j.1524-4725.2012.02417.x. Epub 2012 Jun 12.
The morpheaform subtype of basal cell carcinoma (BCC) often presents a diagnostic histological challenge, and its true margin may be difficult to determine with accuracy. This tumor may also be difficult to distinguish from other adnexal neoplasms having a benign clinical course. Previous work has shown that cytokeratin 17 (CK17 or K17) expression is high in BCC.
To confirm the expression of K17 across the subtypes of superficial, nodular and morpheaform BCC variants and to compare K17 expression in each of these subtypes of BCC with that in two other adnexal neoplasms.
Tissue specimens from each tumor category were randomly collected, immunolabeled, and scored for K17 expression according to intensity and extent of immunostaining.
Our results indicate that K17 is a useful marker in the identification and outlining of BCC. Moreover, in morpheaform BCC, K17 immunostaining clearly detected individual tumor cells well away from the dermal tumor strands that otherwise seemed nonmalignant according to hematoxylin and eosin staining alone. In addition, the expression of K17 in morpheaform BCC is capable (100% of specimens; p < .001) of distinguishing this tumor from desmoplastic trichoepithelioma.
We propose that K17 immunostaining could improve the diagnostic and surgical management of these tumors.
基底细胞癌（BCC）的苔藓样亚型常常在组织学上具有诊断挑战性，其真正边界可能难以准确确定。这种肿瘤也可能难以与其他具有良性临床过程的附属肿瘤区分开来。先前的工作表明，细胞角蛋白 17（CK17 或 K17）在 BCC 中高表达。
确认 CK17 在浅表型、结节型和苔藓样 BCC 变体中的表达，并比较这些 BCC 亚型中 CK17 的表达与另外两种附属肿瘤中的表达。
随机收集每种肿瘤类别的组织标本，进行免疫标记，并根据免疫染色的强度和范围对 CK17 表达进行评分。
我们的结果表明，CK17 是识别和勾勒 BCC 的有用标记物。此外，在苔藓样 BCC 中，CK17 免疫染色可以清楚地检测到远离单独根据苏木精和伊红染色似乎是非恶性的真皮肿瘤束的单个肿瘤细胞。此外，CK17 在苔藓样 BCC 中的表达能够（100%的标本；p <.001）将这种肿瘤与富于细胞性毛鞘瘤区分开来。
我们建议 CK17 免疫染色可以改善这些肿瘤的诊断和手术管理。
