细胞角蛋白CK15、CK18、CK19免疫组化联合检测在部分皮肤肿瘤鉴别诊断中的应用

Application of combined immunohistochemical detection of cytokeratin CK15,CK18 and CK19 in differential diagnosis of some skin tumors

目的:评价细胞角蛋白CK15、CK18、CK19在四种形态学相近的皮肤肿瘤中的表达水平。方法:选择2016年05月至2019年05月在东营市人民医院病理科确诊的脂溢性角化病、基底细胞癌、毛母细胞瘤及汗孔瘤共78例,进行免疫组织化学检测,观察并记录三种细胞角蛋白在上述四种皮肤肿瘤中的表达水平。结果:78例皮肤肿瘤组织中三种CK的表达水平不同。CK15主要在表皮基底层、毛囊、毛母细胞瘤中表达,在脂溢性角化病、基底细胞癌中部分表达,汗孔瘤中周边细胞表达。CK18在皮肤汗腺、汗孔瘤中表达,脂溢性角化病、基底细胞癌、毛母细胞瘤中仅少量表达。CK19在表皮基底层、皮肤附属器外周及上述四种肿瘤中均检测到其表达。CK15在毛母细胞瘤的表达与脂溢性角化病、基底细胞癌、汗孔瘤均存在统计学差异(P<0.05),CK18在汗孔瘤与脂溢性角化病、基底细胞癌及毛母细胞瘤的表达比较中均存在统计学差异(P<0.05),CK19在脂溢性角化病、基底细胞癌的表达中存在统计学差异(P<0.05)。结论:免疫组织化学方法联合检测CK15、CK18、CK19的表达水平可以作为诊断及鉴别诊断这四种皮肤肿瘤的重要辅助方法。

Objective:To evaluate the expression of CK15,CK18 and CK19 in four types of skin tumors with similar histomorphology.Methods:From May 2016 to May 2019,78 cases of seborrheic keratosis,basal cell carcinoma,trichoblastoma and syringoma were selected and detected by immunohistochemistry.The expression levels of cytokeration CK15,CK18 and CK19 in the above skin tumor were observed and recorded.Results:The expression levels of three kinds of CK were different in 78 cases of skin tumors.CK15 was mainly expressed in the basal layer of epidermis,hair follicle and trichoblastoma,partially expressed in seborrheic keratosis and basal cell carcinoma,and in peripheral cells of syringoma.CK18 was expressed in sweat gland and syringoma of skin,but a little in seborrheic keratosis,basal cell carcinoma and trichoblastoma.CK19 was detected in the basal layer of epidermis,the peripheral area of skin appendages,and the above four kinds of tumors.The expression of CK15 in trichoblastoma was significantly different from that in seborrheic keratosis,basal cell carcinoma and syringoma(P<0.05).The expression of CK18 in syringoma was statistically different from that in seborrheic keratosis,basal cell carcinoma and trichoblastoma(P<0.05).The expression of CK19 in seborrheic keratosis and basal cell carcinoma was statistically different(P<0.05).Conclusion:The expression of CK15,CK18 and CK19 can be used as an important assistant method for the diagnosis and differential diagnosis of these four skin tumors with similar histomorphology.