Korean J Dermatol.  2005 Jun;43(6):721-731.

Expression of Ki-67, p27 and Laminin in Actinic Keratosis, Bowen's Disease, and Squamous Cell Carcinoma

Affiliations
  • 1Department of Dermatology, College of Medicine, Korea University, Seoul, Korea. kumcihk@korea.ac.kr

Abstract

BACKGROUND
In many cases, the distinction between actinic keratosis (AK), Bowen's disease (BD), and invasive squamous cell carcinoma (SCC) is not histologically clear. Tumor cells crossing the basement membrane was traditionally the boundary between AK and invasive SCC. However, this criteria may not be practical in day-to-day clinical situations. OBJECTIVE: The purpose of this study was to investigate the expression patterns and labeling index of the immunohistochemical staining of Ki-67, p27 and laminin in AK, BD and SCC, to ascertain whether differential expression patterns of Ki-67, p27 and laminin exist. METHOD: Seventeen cases of AK, 19 cases of BD and 16 cases of SCC were investigated. We performed immunohistochemical staining for Ki-67, p27 and laminin. The patterns of positive nuclear staining were noted as either marginal (positive nuclear staining in the basal and parabasal layers but 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 the tumor aggregates). RESULTS: For Ki-67, a marginal pattern of positive nuclear staining was found 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 the labeling index was 24.5%. In BD, Ki-67-stained nuclei were found throughout the full thickness of the atypical epidermis (diffuse pattern), and the labeling index was 70.5%. The invasive aggregates of SCC had a complex pattern of staining for Ki-67, being diffuse and scattered, and the labeling index was 43.5%. The p27 labeling index in AK, BD and SCC was 86.5%, 91.5% and 67.5%, respectively. The p27 labeling index was significantly decreased in invasive SCC, when compared with those of AK and BD. Laminin was stained strongly and continuously along the basement membrane of the epidermis and vessel walls of normal epidermis, AK and BD. In SCC, laminin was stained along the basement membrane of the tumor nest in well differentiated SCC, and weakly and interrupted in poorly differentiated SCC. CONCLUSION: There results show that the staining pattern of Ki-67 is helpful to differentiate 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), and increased Ki-67 labeling index is helpful to differentiate BD from AK and SCC. A reduced p27 labeling index is helpful to differentiate SCC from AK and BD. However, the staining pattern of laminin did not seem to be helpful in differentiating these diseases.

Keyword

Actinic keratosis; Bowen's disease; Squamous cell carcinoma; Immunohistochemical study; Ki-67; p27; Laminin

MeSH Terms

Actins*
Basement Membrane
Bowen's Disease*
Carcinoma, Squamous Cell*
Epidermis
Epithelium
Keratosis, Actinic*
Laminin*
Actins
Laminin
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