광선각화증, 보웬병, 편평상피세포암에서 Ki-67, p27, Iaminin 발현 양상에 관한 연구
Ki- 7, p27, laminin expression in Actinic keratosis, Bowen's disease, and Squamous cell carcinoma
광선각화증 보웬병 편평상피세포암 Ki-67 p27 laminin;
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Background: In many cases, the distinction between actinic keratosis(AK), Bowen's disease(BD), and invasive squamous cell carcinoma(SCC) is not clear histologically. Traditionally, tumor cells crossing the basement membrane is the boundary between AK and invasive SCC. But, this criteria may not be practical in day-to-day clinical situation. Objective: The purpose of this study is to investigate the expression patterns and labeling index of immunohistochemical staining of Ki-67, p27, laminin in AK, BD, SCC to see if differential patterns of expression for Ki-67, p27, laminin is exist. Methods: We studied 17 cases of AKs, 19 cases of BDs and 16 cases of SCCs. We performed the immunohistochemical staining with Ki-67, p27, laminin. Patterns of positive nuclear staining were noted as either marginal(positive nuclear staining in the basal and parabasal layers and sparing the granular zone) or diffuse(positive nuclear staining in the majority of cells throughout the full thickness of the epithelium or tumor aggregates) and scattered(positive nuclear staining of cells in the focal area of tumor aggregates). Results: Ki-67 was found in marginal pattern in the basal/parabasal cell layer of normal epidermis. In AK, Ki-67-stained nuclei were found in the basal/parabasal cell layers(marginal pattern) and labeling index was 24.5%. In BD, Ki-67-stained nuclei were found throughout the full thickness of the atypical epidermis(diffuse pattern) and labeling index was 70.5%. The invasive aggregates of SCC had a complex pattern of staining for Ki-67, diffuse and scattered and labeling index was 43.5%. p27 labeling index of normal epidermis was 90.3%; and AK, 86.5%; BD, 91.5%; SCC, 67.5%. The p27 labeling index was significantly decreased only in invasive SCC when compared with that of normal epidermis, AK, and BD. Laminin was stained strongly and continuously along the basement membrane of the epidermis and vessel walls of normal epidermis, AK, BD. In SCC, laminin was stained along the basement membrane of the tumor nest in well differentiated SCC, and weekly and interrupted in poorly differentiated SCC. Conclusion: The Ki-67 expression pattern differentiates BD(diffuse pattern throught the full thickness of atypical epidermis) from AK(marginal pattern affecting the basal and parabasal layers) and SCC(diffuse and scattered within the atypical aggregate). Reduced p27 labeling index differentiates SCC from AK, BD.