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2015 ; 94
(23
): e934
Nephropedia Template TP
gab.com Text
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English Wikipedia
Keratoacanthoma and Keratoacanthoma-Like Squamous Cell Carcinoma: Similar
Morphology but Different Pathogenesis
#MMPMID26061320
Watanabe IC
; Magalhães RF
; de Moraes AM
; Stelini RF
; Cintra GF
; Metze K
; Cintra ML
Medicine (Baltimore)
2015[Jun]; 94
(23
): e934
PMID26061320
show ga
Differential diagnosis between keratoacanthoma (KA) and squamous cell carcinoma
(SCC) is difficult due to their similarities. The mechanisms that drive their
distinct biological behavior are poorly understood. To investigate whether the
assessment of microvessel density (MVD) could be helpful in KA and SCC
differential diagnosis and to gain insight into the pathogenesis of KA-like
neoplasms, we compared the density of CD105- and CD34-stained vessels in KAs and
SCCs and their relation to the expression of the p53 oncoprotein and
proliferation marker Ki67. This is an observational retrospective cohort study.
Forty lesions with clinical appearance of KAs (29 KAs and 11 SCCs) entered the
study. A biopsy was taken from each lesion at presentation and the natural
clinical course was monitored for at least 1 month. Growing or minimally
regressing lesions were submitted to complete surgical excision. The diagnoses
were established on combined clinical, histological, and follow-up evaluations.
The MVD and p53 or Ki67 expression in neoplastic cells were assessed through
morphometry. The MVD did not show discriminating power between KAs and SCCs. The
Ki67 proliferation rate was significantly higher in SCCs. Although
neoangiogenesis (CD105-MVD) in KAs was associated with cell proliferation, in
SCCs it was not. There was significant correlation between p53 expression and
neoplasia size in SCCs but not in KAs. From our results, we may conclude that KA
and SCC have similarities, as CD105- and CD34-MVD. However, the low Ki67
proliferation index and the positive correlation between Ki-67 index and
neovascularization in KA suggest a dependence in neovascularization to grow in
KA, pointing to involvement of distinct pathogenesis.