Histopathological varieties of oral carcinoma in situ: Diagnosis aided by immunohistochemistry dealing with the second basal cell layer as the proliferating center of oral mucosal epithelia
Histopathological varieties of oral carcinoma in situ: Diagnosis aided by immunohistochemistry dealing with the second basal cell layer as the proliferating center of oral mucosal epithelia
复制标题
DOI：
10.1111/j.1440-1827.2009.02499.x
复制
发表时间：
2010-03-01
影响因子：
2.2
通讯作者：
Saku, Takashi
中科院分区：
文献类型：
--
作者：
Kobayashi, Takanori;Maruyama, Satoshi;Saku, Takashi
为了对口腔癌（CIS）进行可重复性诊断，我们使用了针对鳞状细胞增殖（Ki-67）和分化（角蛋白(K) 13和K19）定位的联合免疫组织化学方法，这两种方法都通过提供生物学证据来支持组织学评估。正常/增生性上皮仅在第一基底层有K19+细胞，第三基底层和上层有K13+细胞，第二基底层有零星的Ki-67+细胞。说明口腔上皮的增殖中心位于旁基底细胞层，K19和K13可分别作为基底细胞和棘细胞的标记物。上皮异常增生的特征是Ki-67+细胞分层不规则，增殖细胞中缺乏K19/K13。K19+和K13+细胞在增殖灶中不规则出现，非典型Ki-67+细胞的独特分层提示CIS。应用该定义后，172例复发患者的手术切缘包含CIS（39.4%）和鳞状细胞癌（55.8%），说明CIS的新诊断标准反映了患者的临床行为。结果表明，口腔CIS包含更多的组织学变异，特别是那些明确的角化，比以前所定义的。
To make reproducible diagnoses for oral carcinoma in situ (CIS), combined immunohistochemistry directed at the positioning of squamous cell proliferation (Ki-67) and differentiation (keratin (K) 13 and K19) was used, both of which support histological evaluations by providing biological evidence. Normal/hyperplastic epithelia was defined by K19+ cells only in the first basal layer, K13+ cells in the third basal and upper layers, and sporadic Ki-67+ cells in the second basal layer. These profiles indicated that a proliferating center of the oral epithelium is located in the parabasal cell layer, and K19 and K13 can be regarded as markers for basal and prickle cells, respectively. Epithelial dysplasia was characterized by irregular stratification of Ki-67+ cells and the absence of K19/K13 in proliferating cells. Irregular emerging of K19+ and K13+ cells in proliferating foci with unique stratification of atypical Ki-67+ cells indicated CIS. When the definition was applied, surgical margins in 172 recurrent cases were shown to contain CIS (39.4%) and squamous cell carcinoma (55.8%), indicating that the new diagnostic criteria for CIS reflected clinical behaviors of the cases. The results indicate that oral CIS contain more histological variations, especially those with definite keratinization, than what had been previously defined.