角化棘皮瘤的临床与病理分析

Clinical and pathological features of keratoacanthoma

目的:探讨角化棘皮瘤的临床、病理学特征、恶性程度及预后。方法:收集18例角化棘皮瘤患者资料,观察和分析其临床和组织病理学特征,并通过免疫组化方法分析其p53、bcl-2及P-gp的表达。结果:角化棘皮瘤的典型皮损为边界清楚的半球状隆起,中央形成“火山口”样溃疡,其中充满角化物质;组织病理以表皮向真皮内凹陷呈“火山口”状,其中充满角化物质,两侧的上皮细胞形成“唇缘”包绕瘤体为特征;首选手术治疗、长期随访。18例角化棘皮瘤中p53阳性表达明显高于正常对照组(P<0.05),bcl-2、P-gp阳性表达与正常对照组相比没有显著性差异(P>0.05)。结论:角化棘皮瘤为低恶性的皮肤肿瘤,有特殊的临床及组织病理特点,免疫组化有助于判断肿瘤的发病、恶性程度及预后。

Objective：To study the clinical and pathological features,malignancy and prognosis of keratoacanthoma（KA）.Methotis： Eighteen patients with KA were collected, and their clinical features were analyzed with pathological aspects observed by immunohistochemical SP techniques.Results：The typical lesion of KA is a hemispheric,dome-shaped,skin-colored nodule in which there is a smooth crater filled with a central keratin plug.Histological examination showed a crater filled with eosinophilic keratin.A ＂lip＂formed by invagination of epidermis surrounds the keratin-filled crater.Wide excision of the lesions is the first choice for the treatment of KA. The expression levels of p53 was higher than controls （P〈0.05）.No statistical significance were found on the expression of bcl-2 and P-gp.Conclusions：KA is a skin malignant tumor with it＇s typical clinical and pathological features. The diagnosis ,malignancy and prognosis of KA can be confirmed by immunohistochemical staining.