Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwain.
Kaohsiung J Med Sci. 2012 Oct;28(10):545-9. doi: 10.1016/j.kjms.2012.04.017. Epub 2012 Aug 27.
Dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP) are the spindle cell mesenchymal neoplasms of the dermis and subcutis. Their histogenesis still remains uncertain and controversial. Traditionally, CD34 and factor XIIIa or other markers have been widely used to distinguish these two diseases. However, the results of these markers reveal overlapping and they lack specificity. Formalin-fixed, paraffin-embedded blocks were collected from the biopsied cases in Kaohsiung Medical University Hospital in Taiwan between 2004 and 2006. This study included 19 cases of DF and 17 cases of DFSP. Immunohistochemical analysis using antibodies CD34, matrix metalloproteinases (MMP)-2, MMP-9, and MMP-11 was performed. We found that the expression of CD34, MMP-2 and MMP-11 shows significant statistical differences in Immunohistochemistry (IHC) study positive or negative reactivity (positive of CD34 in DFSP and positive of MMP-2 and MMP-11 in DF; p=0.03, p<0.001, and p<0.001, respectively) between DF and DFSP. The result for expression of MMP-9 reveals no differences. The results indicate that the pathogenesis of DF and DFSP are affected by different expressions of extracellular matrix proteins. Metalloproteinases may play a direct role in these two diseases. Since no single marker can completely distinguish DF from DFSP, a combination of more than two or three stains may elevate the accuracy of diagnosis.
隆突性皮肤纤维肉瘤(DFSP)和皮肤纤维瘤(DF)是真皮和皮下组织的梭形细胞间叶性肿瘤。其组织发生仍然不确定且存在争议。传统上,CD34 和因子 XIIIa 或其他标志物被广泛用于区分这两种疾病。然而,这些标志物的结果存在重叠,并且缺乏特异性。本研究收集了台湾高雄医学大学附属医院 2004 年至 2006 年间活检的 19 例 DF 和 17 例 DFSP 病例的福尔马林固定、石蜡包埋块。使用 CD34、基质金属蛋白酶(MMP)-2、MMP-9 和 MMP-11 抗体进行免疫组织化学分析。我们发现,在免疫组织化学(IHC)研究中,CD34、MMP-2 和 MMP-11 的表达在阳性或阴性反应中存在显著的统计学差异(DFSP 中 CD34 阳性,DF 中 MMP-2 和 MMP-11 阳性;p=0.03、p<0.001 和 p<0.001)。MMP-9 的表达结果无差异。结果表明,DF 和 DFSP 的发病机制受细胞外基质蛋白不同表达的影响。金属蛋白酶可能在这两种疾病中发挥直接作用。由于没有单一的标志物可以完全区分 DF 与 DFSP,因此联合使用两种或三种以上的染色剂可能会提高诊断的准确性。