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Abstract：
The use of immunohistochemical markers for myoepithelial cells (MEC) is a useful tool in the distinction of benign from malignant epithelial neoplasms. Although their use in breast tumors is well recognized, little is known concerning its application in comparable cutaneous lesions. Using benign cutaneous cystic apocrine lesions as a study model, the aim of this study was to compare 5 immunohistochemical markers [calponin, p63, smooth muscle actin (SMA), cytokeratin 14, and CD10] in their effectiveness to highlight MEC. Cases of apocrine hidrocystoma and cystadenoma (n = 44) were reviewed with a particular emphasis on proliferative features and apocrine change. The MEC staining pattern and the intensity and distribution scores in proliferative (n = 29) and nonproliferative (n = 15) lesions were assessed, and the differences between the 2 groups were statistically analyzed using Fisher exact test. Calponin and SMA stained MEC in the most consistent manner. Being a nuclear stain, p63 was easy to interpret but typically showed discontinuous staining. Cytokeratin 14 not only effectively highlighted MEC but also stained some luminal epithelial cells in an unpredictable manner. Because of prominent background dermal fibroblast staining, CD10 was often difficult to interpret. Only SMA and p63 showed a statistically significant difference in MEC staining intensity scores between the proliferative and nonproliferative groups. Our results show that immunohistological staining for MEC in benign cystic apocrine lesions of the skin is variable. The authors recommend that a panel of markers that includes calponin and p63 be used and highlight the need for awareness of specific caveats associated with individual markers.
摘要：
使用肌上皮细胞（MEC）的免疫组织化学标记是区分良性和恶性上皮肿瘤的有用工具。尽管它们在乳腺肿瘤中的应用得到了广泛认可，关于其在可比皮肤病变中的应用知之甚少。使用良性皮肤囊性大汗腺病变作为研究模型，这项研究的目的是比较5种免疫组织化学标记[calponin，p63，平滑肌肌动蛋白（SMA），细胞角蛋白14和CD10]在它们的有效性中突出MEC。回顾了大汗腺细胞瘤和囊腺瘤（n=44）的病例，特别强调了增殖特征和大汗腺改变。评估了MEC染色模式以及增殖性（n=29）和非增殖性（n=15）病变的强度和分布评分，两组间的差异采用Fisher精确检验进行统计学分析。钙蛋白和SMA以最一致的方式染色MEC。作为一个核污点，p63易于解释，但通常显示不连续染色。细胞角蛋白14不仅有效地突出MEC,而且以不可预测的方式染色一些腔上皮细胞。由于真皮成纤维细胞染色的突出背景，CD10通常难以解释。只有SMA和p63在增殖和非增殖组之间的MEC染色强度评分中显示出统计学上的显着差异。我们的结果表明，皮肤良性囊性大汗腺病变中MEC的免疫组织学染色是可变的。作者建议使用一组包括calponin和p63的标记，并强调需要意识到与单个标记相关的特定警告。
