Takayama Ryoko, Ansai Shin-Ichi, Ishiwata Toshiyuki, Yamamoto Tetsushi, Matsuda Yoko, Naito Zenya, Kawana Seiji
Departments of *Dermatology, and †Pathology and Integrative Oncological Pathology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
Am J Dermatopathol. 2014 Aug;36(8):655-60. doi: 10.1097/DAD.0b013e31828b6bbf.
Lumican, a member of the small leucine-rich proteoglycan family, regulates the assembly and diameter of collagen fibers in the extracellular matrix of various tissues. The lumican expression correlates with pathological conditions and the growth and metastasis of various malignancies. In cutaneous neoplasms, the lumican expression is lower in advanced-stage malignant melanomas that invade the dermis than in early-stage melanomas. Furthermore, we have recently reported that the expression pattern of lumican is different from that of actinic keratosis and the Bowen disease. Lumican is positive in the poroid cells of intraepidermal sweat ducts; therefore, we examined the expression patterns of lumican in acanthotic-type seborrheic keratosis and Pinkus-type poroma followed by clonal-type seborrheic keratosis and hidroacanthoma simplex. The neoplastic cells of acanthotic-type seborrheic keratosis exhibited positive immunostaining in only 1 of 31 cases (3.23%), whereas the poroid cells of Pinkus-type poroma exhibited positive immunoreactivity in 26 of 28 patients (92.8%). In the hidroacanthoma simplex cases, lumican was expressed in poroid cells forming intraepidermal nests in 22 of 28 patients (78.6%), whereas the neoplastic cells in most cases of clonal-type seborrheic keratosis were negative for lumican. In some seborrheic keratosis cases that were positive for lumican in neoplastic cells, lumican was observed in squamoid cells but not in basaloid cells. Therefore, it is necessary to evaluate the immunoreactivity of lumican in seborrheic keratosis and in basaloid cells. These findings suggest that lumican is a potent differential diagnostic marker that distinguishes hidroacanthoma simplex from clonal-type seborrheic keratosis.
核纤层蛋白是富含亮氨酸的小分子蛋白聚糖家族的成员之一，可调节多种组织细胞外基质中胶原纤维的组装和直径。核纤层蛋白的表达与病理状况以及各种恶性肿瘤的生长和转移相关。在皮肤肿瘤中，侵袭真皮的晚期恶性黑色素瘤中核纤层蛋白的表达低于早期黑色素瘤。此外，我们最近报道，核纤层蛋白的表达模式与光化性角化病和鲍恩病不同。核纤层蛋白在表皮内汗腺导管的类导管细胞中呈阳性；因此，我们检测了核纤层蛋白在棘皮型脂溢性角化病、平卡斯型汗孔瘤、克隆型脂溢性角化病和单纯性汗腺棘皮瘤中的表达模式。棘皮型脂溢性角化病的肿瘤细胞在31例中仅1例呈阳性免疫染色（3.23%），而平卡斯型汗孔瘤的类导管细胞在28例患者中有26例呈阳性免疫反应（92.8%）。在单纯性汗腺棘皮瘤病例中，28例患者中有22例（78.6%）在形成表皮内巢的类导管细胞中表达核纤层蛋白，而大多数克隆型脂溢性角化病病例中的肿瘤细胞核纤层蛋白呈阴性。在肿瘤细胞中核纤层蛋白呈阳性的一些脂溢性角化病病例中，在鳞状细胞中观察到核纤层蛋白，但在基底样细胞中未观察到。因此，有必要评估核纤层蛋白在脂溢性角化病和基底样细胞中的免疫反应性。这些发现表明，核纤层蛋白是区分单纯性汗腺棘皮瘤和克隆型脂溢性角化病的有力鉴别诊断标志物。
