Scurry J, Beshay V, Cohen C, Allen D
Department of Pathology, Mercy Hospital for Women, Melbourne, Victoria, Australia.
Histopathology. 1998 May;32(5):399-404. doi: 10.1046/j.1365-2559.1998.00397.x.
To investigate the malignant potential of lichen sclerosus, a study using the cell proliferation marker Ki67 comparing lichen sclerosus with and without associated squamous cell carcinoma was performed.
Formalin-fixed, paraffin-embedded slides of 13 cases of lichen sclerosus with associated carcinoma, and 31 cases without associated carcinoma, including 16 random cases, seven with epidermal thickening and eight with epidermal thinning, were examined by the immunoperoxidase technique for Ki67, a cell proliferation marker. Ki67 reactivity was mostly seen in the basal and parabasal cells in both groups of lichen sclerosus and this pattern was similar to normal skin, squamous cell hyperplasia and analogous to that of one form of squamous cell carcinoma. There was a mean of 50 Ki67 positive cells per 100 basal cells in lichen sclerosus with associated squamous cell carcinoma; however, in squamous cell hyperplasia adjacent to carcinoma this rose to 90 Ki67 positive cells per 100 basal cells. In lichen sclerosus without associated carcinoma, the random cases had a count of 53 per 100 basal cells, those with epidermal thickening 53 and those with thinning 42. Non-genital normal skin had a count of 71 per 100 basal cells.
The lack of qualitative differences of Ki67 expression in normal skin, in lichen sclerosus with and without carcinoma, in squamous cell hyperplasia and in one form of squamous cell carcinoma indicates that these conditions share a common localized pattern of cell proliferation and does not support or deny the malignant potential of lichen sclerosus. The higher Ki67 count in squamous cell hyperplasia adjacent to carcinoma could indicate premalignancy or a reaction to the carcinoma. In patients without carcinoma, the higher Ki67 count in thickened lichen sclerosus compared to thinned suggests that some or all of the cases of thickened lichen sclerosus were lichen sclerosus with squamous cell hyperplasia or that lichen simplex chronicus superimposed on lichen sclerosus has a higher Ki67 expression or that the distinction between squamous cell hyperplasia and lichen simplex chronicus is only one of terminology.
为研究硬化性苔藓的恶性潜能，进行了一项使用细胞增殖标志物Ki67的研究，比较了伴有和不伴有相关鳞状细胞癌的硬化性苔藓。
采用免疫过氧化物酶技术检测13例伴有癌的硬化性苔藓和31例不伴有癌的硬化性苔藓（包括16例随机病例，7例表皮增厚，8例表皮变薄）福尔马林固定、石蜡包埋切片中的细胞增殖标志物Ki67。两组硬化性苔藓中，Ki67反应大多见于基底细胞和基底旁细胞，这种模式与正常皮肤、鳞状细胞增生相似，也与一种鳞状细胞癌的模式类似。伴有鳞状细胞癌的硬化性苔藓中，每100个基底细胞平均有50个Ki67阳性细胞；然而，癌旁鳞状细胞增生中，每100个基底细胞中Ki67阳性细胞数增至90个。在不伴有癌的硬化性苔藓中，随机病例每100个基底细胞计数为53个，表皮增厚者为53个，表皮变薄者为42个。非生殖器正常皮肤每100个基底细胞计数为71个。
正常皮肤、伴有和不伴有癌的硬化性苔藓以及鳞状细胞增生和一种鳞状细胞癌中Ki67表达缺乏质的差异，表明这些情况具有共同的局部细胞增殖模式，既不支持也不否认硬化性苔藓的恶性潜能。癌旁鳞状细胞增生中较高的Ki67计数可能表明癌前状态或对癌的反应。在无癌患者中，增厚的硬化性苔藓中Ki67计数高于变薄者，提示增厚的硬化性苔藓部分或全部病例为伴有鳞状细胞增生的硬化性苔藓，或慢性单纯性苔藓叠加在硬化性苔藓上具有较高的Ki67表达，或鳞状细胞增生与慢性单纯性苔藓之间的区别仅为术语差异。
