Abstract：
BACKGROUND: Nail squamous cell carcinoma (NSCC) is the most frequent ungual malignant tumor, but its incidence remains low. The histopathological description is sparse. We aim to characterize NSCC histopathological aspects, search for a correlation with clinical subtypes, and investigate immunohistochemistry expression of p16, p53, and Ki67.
METHODS: This retrospective study collected NSCC diagnosed in our dermatology department between 2007 and 2021. The histopathological features were correlated with the clinical signs and immunohistochemistry.
RESULTS: A total of 48 patients were included, and immunohistochemistry was available for 36 of them. Two histopathological patterns became prominent: a blue-basaloid type characterized by koilocytosis (p < 0.001), and a pink-keratinizing type. Mean ages were similar when comparing basaloid and periungual versus keratinizing and subungual (p < 0.001). p16 was positive in 31 of 36 cases: 18 basaloid and 13 keratinizing (p = 0.167). p53 and Ki67 were all abnormal.
CONCLUSIONS: Our study described two histopathological NSCC subtypes and associated them with the two clinical subtypes: the blue-basaloid type, HPV-induced, in situ, of periungual localization in younger males; and the pink-keratinizing type, non-HPV-induced, invasive, of subungual site, in elderly. Immunohistochemistry was not contributing on its own, but p16 positivity associated with basaloid histopathological profile helps support HPV etiology.
METHODS: This retrospective study collected NSCC diagnosed in our dermatology department between 2007 and 2021. The histopathological features were correlated with the clinical signs and immunohistochemistry.
RESULTS: A total of 48 patients were included, and immunohistochemistry was available for 36 of them. Two histopathological patterns became prominent: a blue-basaloid type characterized by koilocytosis (p < 0.001), and a pink-keratinizing type. Mean ages were similar when comparing basaloid and periungual versus keratinizing and subungual (p < 0.001). p16 was positive in 31 of 36 cases: 18 basaloid and 13 keratinizing (p = 0.167). p53 and Ki67 were all abnormal.
CONCLUSIONS: Our study described two histopathological NSCC subtypes and associated them with the two clinical subtypes: the blue-basaloid type, HPV-induced, in situ, of periungual localization in younger males; and the pink-keratinizing type, non-HPV-induced, invasive, of subungual site, in elderly. Immunohistochemistry was not contributing on its own, but p16 positivity associated with basaloid histopathological profile helps support HPV etiology.
摘要：
背景：指甲鳞状细胞癌（NSCC）是最常见的指甲恶性肿瘤，但其发病率仍然很低。组织病理学描述很少。我们的目标是表征NSCC组织病理学方面，寻找与临床亚型的相关性，并检测p16、p53和Ki67的免疫组织化学表达。
方法：这项回顾性研究收集了2007年至2021年在我们皮肤科诊断的NSCC。组织病理学特征与临床体征和免疫组织化学相关。
结果：共纳入48例患者，其中36例可用免疫组织化学。两种组织病理学模式变得突出：以空红细胞增多症（p<0.001）为特征的蓝色基底细胞型，和粉红色角质化类型。比较基底细胞和甲周与角化和甲下的平均年龄相似（p<0.001）。36例中有31例p16阳性：18个基底细胞和13个角化（p=0.167）。p53和Ki67均异常。
结论：我们的研究描述了两种组织病理学的NSCC亚型，并将它们与两种临床亚型相关联：蓝色基底细胞型，HPV诱导，在原地,年轻男性的甲周定位；和粉红色角化型，非HPV诱导，侵入性,subugual网站，在老年人。免疫组织化学本身没有贡献，但与基底细胞样组织病理学特征相关的p16阳性有助于支持HPV病因。
方法：这项回顾性研究收集了2007年至2021年在我们皮肤科诊断的NSCC。组织病理学特征与临床体征和免疫组织化学相关。
结果：共纳入48例患者，其中36例可用免疫组织化学。两种组织病理学模式变得突出：以空红细胞增多症（p<0.001）为特征的蓝色基底细胞型，和粉红色角质化类型。比较基底细胞和甲周与角化和甲下的平均年龄相似（p<0.001）。36例中有31例p16阳性：18个基底细胞和13个角化（p=0.167）。p53和Ki67均异常。
结论：我们的研究描述了两种组织病理学的NSCC亚型，并将它们与两种临床亚型相关联：蓝色基底细胞型，HPV诱导，在原地,年轻男性的甲周定位；和粉红色角化型，非HPV诱导，侵入性,subugual网站，在老年人。免疫组织化学本身没有贡献，但与基底细胞样组织病理学特征相关的p16阳性有助于支持HPV病因。
