Bcl-2、CD10、CD34、CK15表达在基底细胞癌和毛发上皮瘤鉴别诊断中的意义

Significance of Bcl-2、CD10、CD34 and CK15 expression in differentiating basal cell carcinoma from trichoepithelioma

目的:观察Bcl-2、CD10、CD34、CK15在基底细胞癌(BCC)和毛发上皮瘤(TE)中的表达,探讨其在两种肿瘤诊断和鉴别中的作用。方法:对确诊的36例BCC和16例TE石蜡包埋标本行Bcl-2、CD10、CD34、CK15免疫组化染色,观察其在肿瘤细胞及其周围间质中的表达。结果:在BCC和TE中表达的阳性率分别为Bcl-2(栅栏状模式):0、68.75%;CD10(肿瘤细胞染色):72.22%、12.50%;CD10(间质染色)2.78%、62.50%;CD34:0、12.5%;CK15:5.56%、56.25%,其中Bcl-2、CD10、CK15表达差异有统计学意义(P值均<0.01),而CD34表达差异无统计学意义(P>0.05)。灵敏度:CD10(肿瘤细胞染色)72.22%>Bcl-2(68.75%)>CD10(间质染色)62.50%>CK15(56.25%)。特异性:Bcl-2(100%)>CD10(间质染色)97.22%>CK15(94.44%)>CD10(肿瘤细胞染色)87.50%。准确度:Bcl-2(90.38%)>CD10(间质染色)86.54%>CK15(82.69%)>CD10(肿瘤细胞染色)65.38%。阳性预测值:Bcl-2(100%)>CD10(肿瘤细胞染色)92.86%>CD10(间质染色)90.91%>CK15(81.82%)。阴性预测值:Bcl-2(87.80%)>CD10(间质染色)85.37%>CK15(82.92%)>CD10(肿瘤细胞染色)58.33%。结论:Bcl-2、CD10在BCC和TE中表达模式的差异,以及CK15在TE中高表达,有助于这两种肿瘤的鉴别诊断,CD34对于鉴别BCC和TE意义不大。

Objective:To compare expression of Bcl-2,CD10,CD34 and CK15 in basal cell carcinoma(BCC)versus trichoepithelioma(TE),and to explore the significance of their expression in diagnosis and differential diagnosis of these two disorders.Methods:Paraffin-embedded tissue samples from 36 cases of BCC and 16 cases of TE were analyzed using immunohistochemistry of Bcl-2,CD10,CD34 and CK15.The expression of these biomarkers in tumor cells and tumor stroma was evaluated.Results:The positive staining rates of Bcl-2(palisading arrangement)in BCC and TE were 0 and 68.75%respectively(P<0.01),while positive rates of CD10 in tumor cells of BCC and TE were 72.22%and 12.50%respectively(P<0.01).Moreover,positive rates of CD10 in stroma of BCC and TE were 2.78%and 62.50%respectively(P<0.01).Likewise,positive rates of CK15 in BCC and TE were 5.56%and 56.25%,respectively(P<0.01).However,positive rates of CD34 in BCC and TE were comparable(P>0.05).Sensitivities were CD10(Tumour cells+)72.22%>Bcl-2(68.75%)>CD10(Stromal+)62.50%>CK15(56.25%);Specificities were Bcl-2(100%)>CD10(Stromal+)97.22%>CK15(94.44%)>CD10(Tumour cells+)87.50%;Accuracies were Bcl-2(90.38%)>CD10(Stromal+)86.54%>CK15(82.69%)>CD10(Tumour cells+)65.38%;Positive predictive values were Bcl-2(100%)>CD10(Tumour cells+)92.86%>CD10(Stromal+)90.91%>CK15(81.82%);Negative predictive values were Bcl-2(87.80%)>CD10(Stromal+)85.37%>CK15(82.92%)>CD10(Tumour cells+)58.33%.Conclusions:Differentiated expression and distribution of Bcl-2,CD10 and CK15,but not CD34,in BCC and TE can benefit the differential diagnosis of these two tumors.