免疫组化在鉴别老年性外阴部位鲍温样丘疹病和病毒疣感染中的应用

Application of immunohistochemistry in differentiation of Bowenoid papulosis and viral wart infection in vulva of the elderly

中文关键词: 老年  鲍温样丘疹病  病毒疣  HPV  p16  Ki67  免疫组化染色

英文关键词: elderly  Bowenoid papulosis  viral wart  HPV  p16  Ki67  immunohistochemical staining

中文摘要:

      目的 探讨免疫组化在鉴别老年性鲍温样丘疹病和病毒疣感染中的意义.方法 选取于复旦大学附属华山医院皮肤科就诊的100例老年外阴部位鲍温样丘疹病患者和200例老年外阴部位病毒疣感染患者的标本,分别行苏木精-伊红(HE)染色和免疫组化(IHC)染色,观察并分析其结果.结果 100例鲍温样丘疹病患者的皮损免疫组化结果示,全部病例呈p16阳性,其中,96例Ki-67高表达(≥50％);HPV阳性52例,阴性48例.而200例病毒疣患者皮损免疫组化结果显示,11例p16呈部分阳性,另189例阴性;173例Ki-67低表达,27例呈高表达,阳性细胞主要位于颗粒层及棘层上部(除基底层外);HPV阳性99例,阴性101例.其中,94例鲍温样丘疹病患者皮损同时出现p16阳性和Ki-67高表达,而病毒疣患者中仅4例呈现共表达.结论 老年鲍温样丘疹病患者皮损中p16阳性、Ki-67全层高表达,可较好地与病毒疣相鉴别.

英文摘要:

      Objective To investigate the significance of immunohistochemistry(IHC)in differentiating Bowenoid pap-ulosis and viral wart infection in the elderly.Methods The specimens from 100 elderly patients with Bowenoid papulosis in the vulva and 200 elderly ones with viral warts in the vulva who visited Department of Dermatology of Huashan Hospital Affilia-ted to Fudan University were selected.Hematoxylin-Eosin(HE)staining and immunohistochemical staining were performed,respectively.The results were observed and analyzed.Results The immunohistochemical results of the skin lesions of 100 pa-tients with Bowenoid papulosis showed that all cases were p16 positive,among which 96 cases had high expression of Ki-67(≥50％);52 cases were HPV positive and 48 cases were HPV negative.The immunohistochemical results of skin lesions of 200 patients with viral warts showed that 11 cases were partially positive for p16,and the other 189 cases were negative.There were 173 cases with low expression of Ki-67 and 27 cases with high expression.The positive cells were mainly located in the granular layer and the upper part of the spinous layer(except for the basal layer).There were 99 cases positive for HPV and 101 cases negative.In 94 patients with Bowenoid papulosis,both p16 positivity and high expression of Ki-67 were present in the skin lesions simultaneously.However,among patients with viral warts,only 4 cases showed the co-expression.Conclusion In the skin lesions of elderly patients with Bowenoid papulosis,p16 is positive and Ki-67 is highly expressed,which can be well differentiated from viral warts.