Summary
Background
Invasive extramammary Paget's disease (EMPD) is commonly associated with a poor prognosis.
Although early detection of micro invasion can improve the prognosis, diagnosis is
not always straightforward in some EMPD cases. Several clinical studies have proposed
mechanisms underlying the increased invasiveness of EMPD; however, molecular markers
indicative of the invasiveness have yet to be well characterized.
Objective
The purpose of this study was to identify a reliable immunohistochemical marker for
predicting the risk of invasion and metastasis in EMPD cases.
Methods
A total of 32 specimens from 23 primary EMPD cases were analyzed by immunohistochemical
staining. In formalin-fixed, paraffin-embedded tissue sections, immunolabeling of
tumor cells were scored by stain intensity on a four-tiered scale. Using antibodies
against several tumor proliferation markers, such as Her2, p53, Ki-67, cyclin D1 and
Bcl-2, we determined the correlation between the expression of these molecular markers
and the types of EMPD lesions (in situ, invasive or metastatic).
Results
In contrast to Her2, p53 and Bcl-2, which are similarly expressed among different
types of lesions, Ki-67 and cyclin D1 are expressed at significantly higher levels
in invasive lesions than in situ lesions (P < 0.01 and P < 0.05, respectively). Furthermore, the mean of the sum of Ki-67 and cyclin D1 expression
scores was significantly higher in invasive lesions, compared to the scores obtained
for in situ lesions. In addition, the difference was more significant (P ≤ 0.001) than each of these independent marker.
Conclusion
Combined high expression of Ki-67 and cyclin D1 was highly associated with invasive
lesions of EMPD.
Keywords
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Article info
Publication history
Published online: July 12, 2010
Accepted:
December 3,
2007
Received in revised form:
December 3,
2007
Received:
October 29,
2007
Identification
Copyright
© 2007 Japanese Society for Investigative Dermatology. Published by Elsevier Inc. All rights reserved.
