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目的探索皮肤外毛根鞘癌的诊断与鉴别诊断及细胞角蛋白(CK)和原癌基因蛋白(c-erbB-2)的表达与意义。方法应用HE染色观察和免疫组化法对22例外毛根鞘癌和9例鳞状细胞癌(鳞癌)进行高分子角蛋白(CK-H)和低分子角蛋白(CK-L)及c-erbB-2免疫标记。结果外毛根鞘癌的分叶状结构和中央的骤然角化是其独特的形态学特点,也是与鳞癌进行鉴别的重要依据;免疫组化标记,CK-H在外毛根鞘癌的阳性表达率为81.8%(18/22),其阳性细胞分布在癌巢中央角化与周边瘤细胞之间的中间区,与鳞癌的表达不同。c-erbB-2表达阳性率为50%(11/22),阳性细胞分布于癌巢的周边区,且随着分化程度的降低而表达增强。结论外毛根鞘癌的形态学与鳞癌不同,两者的鉴别决定该肿瘤患者的治疗与预后。CK-H免疫组化标记的特殊分布提示其外毛根鞘来源;c-erbB-2参与外毛根鞘癌的激活并与其分化有关。
Objective To explore the diagnosis and differential diagnosis of cutaneous sheath sheath carcinoma and the expression and significance of cytokeratin (CK) and proto-oncogene protein (c-erbB-2). Methods The expression of CK-H, CK-L and c-catenin in 22 cases of exudate root sheath carcinoma and 9 cases of squamous cell carcinoma (squamous cell carcinoma) were detected by HE staining and immunohistochemistry. erbB-2 immunolabeling. Results The lobular structure and central keratinization of the outer sheath root sheath carcinoma were their unique morphological features and important basis for the identification of squamous cell carcinoma. The positive expression rates of CK-H in the outer root sheath sheath carcinoma Was 81.8% (18/22). The positive cells were located in the central area of the cancer nest with the surrounding tumor cells, which was different from that of squamous cell carcinoma. The positive rate of c-erbB-2 expression was 50% (11/22). The positive cells were located in the periphery of the cancer nest, and increased with the decrease of differentiation degree. Conclusions The morphology of sheath hair sheath is different from that of squamous cell carcinoma. The identification of the two determines the treatment and prognosis of the tumor. The special distribution of CK-H immunohistochemical markers indicates the origin of the outer root sheath; c-erbB-2 is involved in the activation of outer root sheath and its differentiation.