Lindberg K, Rheinwald J G
Department of Oral Pathology and Oral Medicine, Harvard School of Dental Medicine, Boston, Massachusetts.
Am J Pathol. 1989 Jan;134(1):89-98.
The authors have studied the expression of keratin 19 in normal oral mucosa and in oral lesions exhibiting a range of histopathologic changes that are thought to precede squamous cell carcinoma. Formalin-fixed, paraffin-embedded sections were pretreated with pronase and stained with a K19-specific antibody by the avidin-biotin immunoperoxidase method. In nonkeratinized mucosa, whether normal or benign hyperplastic, K19 was detectable in the basal cell layer. In keratinized mucosa, whether normal or benign hyperplastic, there was no detectable K19. All lesions from any oral site that exhibited atypia diagnosed from hematoxylin and eosin stained sections as moderate-to-severe dysplasia or carcinoma in situ, whether hyperkeratotic or not, stained strongly for K19 in the basal and suprabasal cell layers. The number of cell layers that were K19-positive correlated with the level in the epithelium to which dysplasia persisted. Suprabasal K19 staining tended to occur in regions of the epithelium in which expression of the terminal differentiation protein involucrin was delayed or absent. Thus, K19 expression may be linked to the retention of stem cell character or a state otherwise uncommitted to terminal squamous differentiation. Suprabasal K19 staining is clearly correlated with premalignant change in oral epithelium and therefore promises to be a useful tool in oral histopathologic diagnosis.
作者研究了角蛋白19在正常口腔黏膜以及呈现一系列组织病理学变化（被认为是鳞状细胞癌前期病变）的口腔病变中的表达情况。采用蛋白酶K预处理福尔马林固定、石蜡包埋切片，并用抗生物素蛋白-生物素免疫过氧化物酶法，以K19特异性抗体进行染色。在非角化黏膜中，无论是正常的还是良性增生的，在基底细胞层均可检测到K19。在角化黏膜中，无论是正常的还是良性增生的，均未检测到K19。任何口腔部位的所有病变，经苏木精-伊红染色切片诊断为中度至重度发育异常或原位癌，无论是否有角化过度，在基底细胞层和基底上层细胞层中K19均呈强阳性染色。K19阳性的细胞层数与发育异常持续存在的上皮层水平相关。基底上层K19染色倾向于出现在终末分化蛋白内披蛋白表达延迟或缺失的上皮区域。因此，K19表达可能与干细胞特征的保留或未完全进行终末鳞状分化的状态有关。基底上层K19染色与口腔上皮的癌前病变明显相关，因此有望成为口腔组织病理学诊断的有用工具。
