Dabner Marcus, McClure Robert J, Harvey Nathan T, Budgeon Charley A, Beer Trevor W, Amanuel Benhur, Wood Benjamin A
1Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre and School of Pathology and Laboratory Medicine, University of Western Australia 2Centre for Applied Statistics, University of Western Australia 3Department of Research, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands 4Clinipath Pathology, WA, Australia *these authors contributed equally to the work.
Pathology. 2014 Apr;46(3):205-10. doi: 10.1097/PAT.0000000000000069.
The aim of this study was to determine the frequency of Merkel cell polyomavirus (MPyV) and p63 positivity by immunohistochemistry in a large cohort of primary Merkel cell carcinoma (MCC) from a region with high rates of actinic damage. We also aimed to determine whether there is any relationship between these markers and histological correlates of chronic sun exposure and to identify whether these markers have prognostic significance in our population. Ninety-five cases of primary cutaneous MCC were identified and stained with immunohistochemical markers for MPyV and p63. The presence of solar elastosis and squamous dysplasia in the overlying/adjacent skin were recorded as markers of actinic damage. Follow up data were obtained from the Western Australian Cancer Registry. MPyV was detected by immunohistochemistry in 23% of cases. There was a statistically significantly lower rate of positivity in tumours associated with markers of chronic sun damage as assessed by the presence of solar elastosis and squamous dysplasia. There was no association with overall or disease specific survival. p63 positivity was detected in 17% of cases. There was no association with markers of actinic damage or with overall or disease specific survival.Our data demonstrate a significant difference in rates of immunohistochemical positivity for MPyV between MCC in sun-damaged and non-sun-damaged sites. This may go some way to explaining previously identified geographical differences. When compared with a number of studies from Europe and North America, p63 positivity is less common in our population and does not show the strong prognostic significance that has been found in these other regions.
本研究的目的是通过免疫组织化学方法，确定来自光化损伤高发地区的一大组原发性默克尔细胞癌（MCC）中默克尔细胞多瘤病毒（MPyV）和p63阳性的频率。我们还旨在确定这些标志物与慢性阳光照射的组织学相关性之间是否存在任何关系，并确定这些标志物在我们的人群中是否具有预后意义。鉴定出95例原发性皮肤MCC，并使用针对MPyV和p63的免疫组织化学标志物进行染色。记录上层/相邻皮肤中日光性弹力组织变性和鳞状发育异常的存在情况，作为光化损伤的标志物。随访数据来自西澳大利亚癌症登记处。通过免疫组织化学在23%的病例中检测到MPyV。根据日光性弹力组织变性和鳞状发育异常的存在情况评估，与慢性阳光损伤标志物相关的肿瘤中，阳性率在统计学上显著较低。与总生存率或疾病特异性生存率无关。在17%的病例中检测到p63阳性。与光化损伤标志物、总生存率或疾病特异性生存率均无关。我们的数据表明，在阳光损伤部位和未受阳光损伤部位的MCC中，MPyV免疫组织化学阳性率存在显著差异。这可能在一定程度上解释了先前发现的地理差异。与欧洲和北美的一些研究相比，p63阳性在我们的人群中不太常见，并不能显示出在其他地区所发现的强烈预后意义。
