The Difference Between BCL-2 And CK15 Expression Of Trichoepithelioma And Basal Cell Carcinoma

Objective:Trichoepithelioma(TE) is a benign cutaneous neoplasm,but it may bear a resemblance to the Basal cell carcinoma(BCC),a malignant tumor of skin.Although they are different in biological sources and in optimum and malignance,they are difficult to identify in both the clinical manifestations and pathological aspects.pathological aspects. TE tends to occur on the face, skin-colored,translucent.They are solid texture papules,and will form plaques after years of growth,sometimes with visible telangiectasia.The nodular ulcerative type of BCC has a tendency to occur on the head and face, skin-colored,light brown or grayish white,translucent.They are solitary papules or tubercle,with visible telangiectasia,and grow slowly.In the centre are erosion or ulcer,surrounded by pearl-like uplifts.It is difficult in early period to distinguish between the two. In histopathology,TE is composed of the tumor mass and keratin cyst.The former is composed of basophils, similar to basal cell carcinoma,palisade-shaped edge;the latter has completely cornified keratinocytes in the centre,with the visible palisade-arranged cells on the edge and cracks between the tumor and the surrounding interstitia.BCC has following pathological manifestations:tumor body is mainly composed of clusters of basal-like cells,which are palisade-arranged around the tumor. There is mixtures of single dead cells,fiber mucous stroma and necrotic material.Both tumor and sroma form "round-cancer gap".However, the clinical treatment Trichoepithelioma and basal cell carcinoma and prognosis have significantly different, therefore,both to make the correct pathological diagnosis,the choice of treatment options and prognosis of clinical judgment has important significance.The purpose of this study is that the method of immunohistochemical staining was observed BCL-2 and CK15 expression in different TE and BCC lesions explore its significance for clinical provide a new approach to the differential diagnosis of TE and BCC.Methods:By SP immunohistochemical method detected 22 cases of facial skin nodular basal cell carcinoma and 12 cases of patients Trichoepithelioma skin samples,paraffin-embedded tissue specimens difference in expression levels of BCL-2 and CK15 expression patterns. Using statistical software SPSS13.0 was used for statistical and processing.Analysis of BCL-2 and CK15 in Trichoepithelioma positive expression rates and differential expression patterns, try to provide a viable method for the clinical differential diagnosis Trichoepithelioma and basal cell carcinoma.Results:The two groups were comparable for the expression rate and patterns of Bcl-2(86.4%: 5 central, 14 diffuse in BCC vs. 83.3%:2 central,8 diffuse in TE;P=0.59 and 0.54 for rate and pattern, respectively);The rate of CK15 expression was significantly higher in TE specimens(66.7%:4 central, 3 diffuse, 1 peripheral vs. 4.5%:1 central; P<0.001). The positive likelihood ratio in distinguishing the two neoplasms was 14.7(95% confidence interval).Conclusions:1 CK15 but not Bcl-2 staining may help in differentiating between BCC and TE even in BCCs with follicular differentiation.2The immunohistochemical staining of CK15 and BCL-2 is not usefulness to distinguish the TEs form BCCs, as well.