Application of immunohistochemical staining of bcl-2, Ber-EP4, CD10, CK20, and Ki-67 in differential diagnosis between trichoblastoma and basal cell carcinoma
10.3760/cma.j.cn112151-20200722-00587
- VernacularTitle:Bcl-2、Ber-EP4、CD10、CK20和Ki-67免疫组织化学染色在毛母细胞瘤和基底细胞癌鉴别诊断中的应用
- Author:
Zhaochao ZHANG
1
;
Jue HU
;
Yunyi KONG
;
Min REN
;
Xu CAI
Author Information
1. 复旦大学附属肿瘤医院病理科，上海 200032
- Keywords:
Skin neoplasms;
Carcinoma, basal cell;
Immunohistochemistry;
Diagnosis, differential
- From:
Chinese Journal of Pathology
2021;50(4):376-381
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the utility of immunohistochemistry (IHC) in differential diagnosis between trichoblastoma (TB) and basal cell carcinoma (BCC).Methods:Fifty-eight cases of TB and 40 cases of BCC were collected at Fudan University Shanghai Cancer Center from January 2009 to December 2019 and retrospectively analyzed by IHC for bcl-2, Ber-EP4, CD10, CK20 and Ki-67. Fisher exact test was performed for statistical analysis.Results:Twenty-five (43.1%) TBs and 5 (12.5%) BCCs showed bcl-2 staining in the outermost layer of the epithelial nests, the difference was statistically significant ( P<0.01). The proportion of cases with bcl-2 staining>75% of epithelial cells in BCC group was much higher than that in TB group (40% vs. 12.1%; P<0.01). BCC group showed larger proportions with Ber-EP4 staining>75%, 51%-75% of epithelial cells than TB group (12.5% vs. 1.7%, 37.5% vs. 8.6%; P<0.05). Fifty-five (94.8%) TBs demonstrated CD10 expression in the follicular stroma, while only 16 (40.0%) BCCs showed focal or scattered CD10 expression in reactive fibrous stroma ( P<0.01). CK20 expression was present in 37 (63.8%) TBs with scattered pattern, but BCCs exhibited no CK20 staining except for only one case (2.5%) showing focal staining ( P<0.01). Compared with TB group, the BCC group included more cases with Ki-67 labeling index ≥15% on average and ≥25% in hotspot areas ( P<0.05). Conclusion:IHC is helpful in differential diagnosis between TB and BCC. Scattered CK20 staining pattern and stromal CD10 expression support the diagnosis of TB. Bcl-2 staining limited to the outermost layer of the proliferation is more likely to be found in TB. In contrast, Ber-EP4 positivity and higher Ki-67 labeling index tend to be present in BCC.
