Goto Keisuke, Ishikawa Misawo, Hamada Kengo, Muramatsu Koji, Naka Miho, Honma Keiichiro, Sugino Takashi
Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan.
Am J Dermatopathol. 2021 Nov 1;43(11):781-787. doi: 10.1097/DAD.0000000000001901.
Distinguishing porocarcinoma from squamous cell carcinoma (SCC) is clinically significant; however, differential diagnosis can often be challenging. This study sought to confirm the diagnostic utility of cytokeratin 19, c-KIT, BerEP4, GATA3, and NUTM1 immunohistochemistry in distinguishing porocarcinoma from SCC. Immunohistochemical analysis of cytokeratin 19, c-KIT, BerEP4, GATA3, and NUTM1 in 14 porocarcinomas and 22 SCCs was performed; the extents and intensities of expression of these markers were recorded. The statistical associations of the immunoexpression between porocarcinoma and SCC were analyzed using the Pearson χ2 test. Cytokeratin 19 was positive in 13 (92.9%) of 14 porocarcinomas, and for all the positive cases, staining was strong and evident in >20% of the tumor cells. By contrast, 9 (40.9%) of 22 SCCs expressed cytokeratin 19 (P = 0.0018), of which 6 showed extremely focal (≤10% of the tumor cells) expression. Of the 14 porocarcinomas, 11 (78.6%) cases showed c-KIT positivity, whereas only 3 of 22 SCCs (13.6%) expressed c-KIT focally (P = 0.0001). In addition, BerEP4 immunostaining differed between porocarcinomas and SCCs (57.1% vs. 9.1%, respectively; P = 0.0017). However, no significant difference between the groups was reported in terms of GATA3 expression (57.1% vs. 72.7%, respectively; P = 0.3336). NUTM1 was expressed in 4/14 (28.6%) porocarcinomas but not in the SCCs. Immunohistochemistry for cytokeratin 19, c-KIT, and BerEP4 could be helpful in distinguishing porocarcinomas from SCCs. In addition, NUTM1 immunoexpression is highly specific, although not sensitive, to porocarcinomas. GATA3 immunohistochemistry has no meaningful implications in the differential diagnosis of porocarcinoma and SCC.
鉴别大汗腺癌与鳞状细胞癌（SCC）具有临床意义；然而，鉴别诊断往往具有挑战性。本研究旨在证实细胞角蛋白19、c-KIT、BerEP4、GATA3和NUTM1免疫组化在大汗腺癌与SCC鉴别诊断中的应用价值。对14例大汗腺癌和22例SCC进行细胞角蛋白19、c-KIT、BerEP4、GATA3和NUTM1的免疫组化分析；记录这些标志物的表达范围和强度。采用Pearson χ2检验分析大汗腺癌与SCC免疫表达之间的统计学关联。细胞角蛋白19在14例大汗腺癌中的13例（92.9%）呈阳性，所有阳性病例中，>20%的肿瘤细胞染色强烈且明显。相比之下，22例SCC中有9例（40.9%）表达细胞角蛋白19（P = 0.0018），其中6例呈极局灶性（≤10%的肿瘤细胞）表达。在14例大汗腺癌中，11例（78.6%）病例显示c-KIT阳性，而22例SCC中只有3例（13.6%）局灶性表达c-KIT（P = 0.0001）。此外，大汗腺癌与SCC的BerEP4免疫染色不同（分别为57.1%和9.1%；P = 0.0017）。然而，两组之间在GATA3表达方面未报告有显著差异（分别为57.1%和72.7%；P = 0.3336）。NUTM1在4/14（28.6%）的大汗腺癌中表达，但在SCC中未表达。细胞角蛋白19、c-KIT和BerEP4的免疫组化有助于鉴别大汗腺癌与SCC。此外，NUTM1免疫表达对大汗腺癌具有高度特异性，尽管不敏感。GATA3免疫组化在大汗腺癌与SCC的鉴别诊断中没有意义。
