Leblebici Cem, Bambul Sığırcı Buket, Kelten Talu Canan, Koca Sevim Baykal, Huq Gülben Erdem
1 Istanbul Education and Research Hospital, Istanbul, Turkey.
Int J Surg Pathol. 2019 Feb;27(1):19-27. doi: 10.1177/1066896918781719. Epub 2018 Jun 25.
Trichoblastoma (TB) and basal cell carcinoma (BCC) are 2 different neoplasms composed of basaloid cells and have overlapping histopathological features. We compared the immunoexpression of CD10, T-cell death-associated gene 51 (TDAG51), cytokeratin 20 (CK20), androgen receptor (AR), insulinoma-associated protein 1 (INSM1), and nestin for the differential diagnosis of these tumors.
We assessed a total of 27 BCC and 27 TB cases, including 4 TB lesions in nevus sebaceous and 3 malignant TB lesions for CD10, TDAG51, CK20, AR, INSM1, and nestin expression.
Staining for CK20, TDAG51, INSM1, and stromal CD10 was significantly more common in TB cases than in BCC cases ( P < .001). Epithelial CD10 and AR staining was significantly more common in BCC cases than in TB cases ( P < .001). The difference between the groups for nestin staining was not significant ( P > .05). Stromal CD10 staining was the most sensitive marker (96.3%) and INSM1 the least sensitive (55.6%) marker for TB. TDAG51 showed 100% specificity for TB. A larger number of CK20 positive cells was found in the cases associated with nevus sebaceous than in the other TBs.
All the selected markers except nestin were useful for the differential diagnosis between TB and BCC. CD10 and TDAG51 were more useful than the other markers. The use of CK20 could be preferred in nevus sebaceous lesions. INSM1 was less effective in highlighting Merkel cells within the lesion than CK20.
毛母细胞瘤（TB）和基底细胞癌（BCC）是由基底样细胞组成的两种不同肿瘤，具有重叠的组织病理学特征。我们比较了CD10、T细胞死亡相关基因51（TDAG51）、细胞角蛋白20（CK20）、雄激素受体（AR）、胰岛素瘤相关蛋白1（INSM1）和巢蛋白的免疫表达，以用于这些肿瘤的鉴别诊断。
我们评估了总共27例BCC和27例TB病例，包括4例皮脂腺痣中的TB病变和3例恶性TB病变的CD10、TDAG51、CK20、AR、INSM1和巢蛋白表达。
CK20、TDAG51、INSM1和基质CD10染色在TB病例中比在BCC病例中显著更常见（P <.001）。上皮CD10和AR染色在BCC病例中比在TB病例中显著更常见（P <.001）。巢蛋白染色在两组之间的差异不显著（P>.05）。基质CD10染色是TB最敏感的标志物（96.3%），而INSM1是最不敏感的标志物（55.6%）。TDAG51对TB显示出100%的特异性。与其他TB相比，皮脂腺痣相关病例中发现的CK20阳性细胞数量更多。
除巢蛋白外，所有选定的标志物都有助于TB和BCC的鉴别诊断。CD10和TDAG51比其他标志物更有用。在皮脂腺痣病变中，CK20的应用可能更可取。与CK20相比，INSM1在突出病变内的默克尔细胞方面效果较差。
