Schulz T, Hartschuh W
Department of Dermatology, University of Heidelberg, Germany.
J Cutan Pathol. 1997 Jan;24(1):14-24. doi: 10.1111/j.1600-0560.1997.tb00780.x.
The possibility of a neuroendocrine differentiation in basal cell carcinomas (BCCs) has been a matter of debate for many years. In the present immunohistochemical study, applying the cytokeratins 8, 18 and 20 as the most established markers for Merkel cells (MCs), we did not find elevated numbers of MCs in any of 205 BCCs. This speaks against a neuroendocrine line of differentiation in BCCs. In contrast, we found various amounts of MCs in 15 of 36 trichoblastomas, which are the main benign differential diagnosis of BCC. In 4 trichoblastomas abundant MCs were spread over the whole epithelial tumor area. Additionally, the trichoblastomas' overlying epidermis exhibited significantly much higher numbers of MCs than the uninvolved adjacent skin or the epidermis overlying the BCCs. These findings might be an additional aid in the distinction between trichoblastomas and BCCs. Furthermore, concerning the recent discussion about the role of MC in growth and development of follicular germ, our observations are another sign of regulative influences of the MC, also in follicular germ under pathological conditions. Trichoblastomas with high numbers of MCs could be characterized as showing advanced differentiation toward the neuroendocrine component of the hair follicle, i.e., the MCs.
多年来，基底细胞癌（BCC）中存在神经内分泌分化的可能性一直是个有争议的问题。在目前的免疫组织化学研究中，我们将细胞角蛋白8、18和20作为默克尔细胞（MC）最常用的标志物，在205例BCC中均未发现MC数量增加。这表明BCC不存在神经内分泌分化途径。相比之下，我们在36例毛发母细胞瘤中有15例发现了不同数量的MC，毛发母细胞瘤是BCC主要的良性鉴别诊断对象。在4例毛发母细胞瘤中，大量MC分布于整个上皮肿瘤区域。此外，毛发母细胞瘤上方的表皮显示出的MC数量明显高于未受累的相邻皮肤或BCC上方的表皮。这些发现可能有助于进一步区分毛发母细胞瘤和BCC。此外，鉴于最近关于MC在毛囊胚芽生长和发育中作用的讨论，我们的观察结果也是MC在病理条件下对毛囊胚芽具有调节作用的另一个迹象。具有大量MC的毛发母细胞瘤的特征可能是向毛囊的神经内分泌成分即MC表现出高级分化。
