Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens

Mostafa, Naglaa A.; Assaf, Magda; Elhakim, Sami; Abdel‐Halim, Mona R. E.; El‐Nabarawy, Eman; Gharib, Khaled

doi:10.1111/cup.13305

Cited by 9 publications

(18 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Different IHC staining distinguishes benign basaloid follicular tumors, such as TB and TE from malignant BCC. A highly sensitive and specific antibody, PHLDA1, has recently been used . Unfortunately, we could not obtain a good staining, despite using several different clones and following the same procedure described in the literature.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Basaloid tumors arising from seborrheic keratosis: Malignant basal cell carcinoma or benign basaloid follicular hamartomatous proliferation?

Flordelis

Shen

2019

J Cutan Pathol

View full text Add to dashboard Cite

Background: Basaloid tumors arising from seborrheic keratosis (SK) that resembled basal cell carcinoma (BCC) were infrequently observed in our patients. They also exhibited morphologic features similar to those of trichoblastoma or basaloid follicular hamartoma. Methods:We retrospectively collected cases of SK with basaloid tumors from 2001 to 2017. Ten cases of BCC, five of nevus sebaceus with trichoblastoma, five of trichoblastoma, and five of trichoepithelioma were included as controls. Tumorassociated antigens Bcl-2, CD10, PHLDA1, and CK20 were tested. Antigenic markers CD34 and CD10 were used to analyze peritumoral stroma features and Ki-67 and pHH3 to measure the mitotic activity.Results: Ten cases of SK with basaloid tumors were found and all located in non-sunexposed areas, including five men and five women, with a mean age of 61 years. A distinct PHLDA1 staining was not observed. The staining patterns of basaloid tumor lobules associated with SK were similar to the benign control group. Bcl-2 staining in the tumor lobules was mostly negative. Peritumoral CD10 stain and CK20-positive Merkel cells in the lobules were observed and the mitotic counts were low.Conclusion: Basaloid tumors arising from SK are not always BCC. They were all benign follicular hamartomatous proliferation in this case series. K E Y W O R D S basal cell carcinoma, basaloid tumor, follicular induction, immunohistochemistry, seborrheic keratosis

show abstract

Section: Discussionmentioning

confidence: 97%

“…Moreover, among previous reported cases, many were diagnosed solely based on hematoxylin and eosin staining, CK19 positivity, or BerEP4 positivity . These stains can help distinguish basaloid cells from squamous cells but cannot differentiate benign basaloid follicular proliferation from BCC …”

Section: Discussionmentioning

confidence: 99%

Basaloid tumors arising from seborrheic keratosis: Malignant basal cell carcinoma or benign basaloid follicular hamartomatous proliferation?

Flordelis

Shen

2019

J Cutan Pathol

View full text Add to dashboard Cite

show abstract

“…Twelve studies 3,7,14,[16][17]19,[21][22][23][24][25] out of the 15 included studies were low risk in the risk of bias assessment and applicability concerns (Figure 2). Three studies 11,18,20 had unclear risk of bias in the index test component since it was not specified whether the slides were assessed independently.…”

Section: Assessment Of Risk Of Bias In the Included Studiesmentioning

confidence: 99%

“…Seven of the studies were from the USA, 6,11,[20][21][22][23]25 two each from Iran 18,19 and Turkey, 3,7 one each from Brazil, 16 Germany, 24 Netherlands, 17 and Egypt. 14…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…12,13 Findings on cluster of differentiation 10 (CD10) expressions have been positive in both BCC and TE but with differences in patterns of staining. 14 This systematic review aims to determine which among the immunohistochemical biomarkers of AR, CK19, PHLDA1, CD10, and Ki67 are significantly associated with BCC or TE and therefore can be used in the initial immunohistochemical panel to assist in the distinction between these two follicular neoplasms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Immunohistochemical Expression of CK19, AR, PHLDA1, CD10 and Ki67 in the Differentiation between Trichoepithelioma and Basal Cell Carcinoma: A Systematic Review

Cubillan¹,

Gatmaitan-Dumlao²

2021

Acta Med Philipp

View full text Add to dashboard Cite

Background. Basal cell carcinoma (BCC) and trichoepithelioma (TE) are follicular adnexal neoplasms that arise from the follicular germ but with divergent biological behavior. The gold standard in the differentiation is through histopathological examination using hematoxylin and eosin (H and E) stain. There are cases, however, when the distinction is not straightforward. Objective. To assess the association and diagnostic accuracy of the immunohistochemical (IHC) expressions of CD10, Ki67, CK19, androgen receptor (AR), and PHLDA1 in distinguishing between basal cell carcinoma and trichoepithelioma. Methods. We conducted a comprehensive search on cross-sectional studies on human tissue from 2000 to 2020 in MEDLINE (PubMed), CENTRAL and EMBASE for comparative studies and reference lists. The data were summarized and analyzed using Microsoft Excel and RevMan. We used Chi-square test for independence, summary receiver operator curves (sROC), and diagnostic odds ratio (OR). Results. We included 15 articles containing 686 BCC and 367 TE in the systematic review. The pooled staining of biomarkers showed a significant difference in the staining of CK19 (p<0.05) and AR (p<0.0001), and PHLDA1 (p<0.0001). Diagnostic odds ratio was used to confirm these associations. AR was found to have the highest odds in the diagnosis of BCC (OR 27.92, 95% CI 10.69, 72.86). The pattern of staining of CD10 is significant (p<0.001) with staining of both tumor and stroma (OR 8.09, 95% CI 4.57, 13.53) and staining of tumor alone (OR 8.15, 95% CI 4.56, 14.35) (p<0.001) in the diagnosis of BCC. CD10 stromal staining, on the other hand, is significantly associated with the diagnosis of TE (OR 7.26, 95% CI 5.06, 10.44) (p<0.0001). There is no significant association between Ki67 staining (OR 1.22, 95% CI 0.48, 3.09) (p=0.67) and the diagnosis of BCC. The forest plot and sROC showed that AR had high specificity across all included studies in the diagnosis of basal cell carcinoma, while PHLDA1 demonstrated high specificity and high sensitivity in diagnosing trichoepithelioma. Conclusion. The biomarkers AR and PHLDA1 are useful as an initial panel to distinguish between BCC and TE, given that both showed high sensitivity as well as significant association with BCC and TE respectively. CD10 and CK19 may also be used with AR and PHLDA1 for further confirmation.

show abstract

Skin Tumors

Elgart

2021

Tips and Tricks in Plastic Surgery

View full text Add to dashboard Cite

Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens

Abstract: The analysis of CD10, Ki-67, and PHLDA1 can be used as a helpful immunohistochemical panel in the distinction between TE and BCC especially in small and superficial biopsies.

Cited by 9 publications

References 30 publications

Basaloid tumors arising from seborrheic keratosis: Malignant basal cell carcinoma or benign basaloid follicular hamartomatous proliferation?

Basaloid tumors arising from seborrheic keratosis: Malignant basal cell carcinoma or benign basaloid follicular hamartomatous proliferation?

Immunohistochemical Expression of CK19, AR, PHLDA1, CD10 and Ki67 in the Differentiation between Trichoepithelioma and Basal Cell Carcinoma: A Systematic Review

Skin Tumors

Contact Info

Product

Resources

About