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Fromme JE, Zigrino P. The Role of Extracellular Matrix Remodeling in Skin Tumor Progression and Therapeutic Resistance. Front Mol Biosci 2022; 9:864302. [PMID: 35558554 PMCID: PMC9086898 DOI: 10.3389/fmolb.2022.864302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/23/2022] [Indexed: 12/12/2022] Open
Abstract
The extracellular matrix remodeling in the skin results from a delicate balance of synthesis and degradation of matrix components, ensuring tissue homeostasis. These processes are altered during tumor invasion and growth, generating a microenvironment that supports growth, invasion, and metastasis. Apart from the cellular component, the tumor microenvironment is rich in extracellular matrix components and bound factors that provide structure and signals to the tumor and stromal cells. The continuous remodeling in the tissue compartment sustains the developing tumor during the various phases providing matrices and proteolytic enzymes. These are produced by cancer cells and stromal fibroblasts. In addition to fostering tumor growth, the expression of specific extracellular matrix proteins and proteinases supports tumor invasion after the initial therapeutic response. Lately, the expression and structural modification of matrices were also associated with therapeutic resistance. This review will focus on the significant alterations in the extracellular matrix components and the function of metalloproteinases that influence skin cancer progression and support the acquisition of therapeutic resistance.
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Affiliation(s)
- Julia E. Fromme
- Department of Dermatology and Venereology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Mildred Scheel School of Oncology Aachen Bonn Cologne Düsseldorf (MSSO ABCD), Cologne, Germany
| | - Paola Zigrino
- Department of Dermatology and Venereology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- *Correspondence: Paola Zigrino,
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Laurito TL, França FT, Vieira-Damiani G, Pelegati VB, Baratti MO, de Carvalho HF, Cesar CL, de Moraes AM, Cintra ML, Teixeira F. The texture of collagen in the microenvironments of Merkel cell carcinoma. Medicine (Baltimore) 2021; 100:e27925. [PMID: 34964766 PMCID: PMC8615296 DOI: 10.1097/md.0000000000027925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023] Open
Abstract
ABSTRACT Solid tumors typically contain high levels of fibrillar collagen. The increased stromal collagen deposition usually promotes cancer progression since biochemical and biophysical cues from tumor-associated collagen fibers stimulate neoplastic cells. Few studies have investigated the relationship between Merkel cell carcinoma (MCC) and the extracellular matrix (ECM), but there are no works evaluating collagen.This is an observational, analytical, retrospective study including 11 patients with MCC. Primary tumor-stained sections were evaluated by second harmonic generation microscopy and texture analysis.Peritumoral texture features (area fraction, mean gray value, entropy, and contrast) showed much lower values than normal skin (P < .0001) revealing extensively altered structure of peritumoral collagen fibers. These differences were not significant between tumors with unfavorable and favorable known prognostic factors.Profound changes in collagen fibers present in the stroma accompanying primary MCC may contribute to the aggressive behavior of this tumor. Our results indicate that whatever MCC histological subtype, size or anatomical location, MCC promotes the same type of ECM for its development. As an outlook, therapies using ECM macromolecules or fibroblasts (the architects of ECM remodeling) as target could be useful in the treatment of MCC.
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Affiliation(s)
- Tiago Luders Laurito
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Flávia Thomé França
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Gislaine Vieira-Damiani
- Federal Institute of Education, Science and Technology of São Paulo, Avenida Ênio Pires de Camargo, 2971, Capivari, SP, Brazil
| | - Vitor Bianchin Pelegati
- National Institute of Photonics Applied to Cell Biology, Department of Quantum Electronics, Institute of Physics, State University of Campinas, Rua Sergio Buarque de Holanda, 777, SP, Brazil
| | - Mariana Ozello Baratti
- National Institute of Photonics Applied to Cell Biology, Department of Quantum Electronics, Institute of Physics, State University of Campinas, Rua Sergio Buarque de Holanda, 777, SP, Brazil
| | - Hernandez Faustino de Carvalho
- National Institute of Photonics Applied to Cell Biology, Department of Quantum Electronics, Institute of Physics, State University of Campinas, Rua Sergio Buarque de Holanda, 777, SP, Brazil
| | - Carlos Lenz Cesar
- National Institute of Photonics Applied to Cell Biology, Department of Quantum Electronics, Institute of Physics, State University of Campinas, Rua Sergio Buarque de Holanda, 777, SP, Brazil
| | - Aparecida Machado de Moraes
- Department of Dermatology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Maria Letícia Cintra
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Fernanda Teixeira
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
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The Roles of Matricellular Proteins in Oncogenic Virus-Induced Cancers and Their Potential Utilities as Therapeutic Targets. Int J Mol Sci 2017; 18:ijms18102198. [PMID: 29065446 PMCID: PMC5666879 DOI: 10.3390/ijms18102198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 12/13/2022] Open
Abstract
Matricellular proteins differ from other classical extracellular matrix proteins; for instance, they are transiently expressed as soluble proteins rather than being constitutively expressed in pathological conditions, such as acute viral infections. Accumulating studies have revealed that matricellular proteins, including osteopontin and tenascin-C, both of which interact with integrin heterodimers, are involved in inflammatory diseases, autoimmune disorders, and cancers. The concentrations of these matricellular proteins are elevated in the plasma of patients with certain types of cancers, indicating that they play important roles in oncogenesis. Chronic viral infections are associated with certain cancers, which are distinct from non-viral cancers. Viral oncogenes play critical roles in the development and progression of such cancers. It is vital to investigate the mechanisms of tumorigenesis and, particularly, the mechanism by which viral proteins induce tumor progression. Viral proteins have been shown to influence not only the viral-infected cancer cells, but also the stromal cells and matricellular proteins that constitute the extracellular matrix that surrounds tumor tissues. In this review, we summarize the recent progress on the involvement of matricellular proteins in oncogenic virus-induced cancers to elucidate the mechanism of oncogenesis and consider the possible role of matricellular proteins as therapeutic targets in virus-induced cancers.
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Tenascin-C and fibronectin expression divide early stage tongue cancer into low- and high-risk groups. Br J Cancer 2017; 116:640-648. [PMID: 28095396 PMCID: PMC5344290 DOI: 10.1038/bjc.2016.455] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/18/2016] [Accepted: 12/20/2016] [Indexed: 12/23/2022] Open
Abstract
Background: Oral tongue squamous cell carcinoma (OTSCC) metastasises early, especially to regional lymph nodes. There is an ongoing debate on which early stage (T1-T2N0) patients should be treated with elective neck dissection. We need prognosticators for early stage tongue cancer. Methods: Mice immunisation with human mesenchymal stromal cells resulted in production of antibodies against tenascin-C (TNC) and fibronectin (FN), which were used to stain 178 (98 early stage), oral tongue squamous cell carcinoma samples. Tenascin-C and FN expression in the stroma (negative, moderate or abundant) and tumour cells (negative or positive) were assessed. Similar staining was obtained using corresponding commercial antibodies. Results: Expression of TNC and FN in the stroma, but not in the tumour cells, proved to be excellent prognosticators both in all stages and in early stage cases. Among early stages, when stromal TNC was negative, the 5-year survival rate was 88%. Correspondingly, when FN was negative, no cancer deaths were observed. Five-year survival rates for abundant expression of TNC and FN were 43% and 25%, respectively. Conclusions: Stromal TNC and, especially, FN expressions differentiate patients into low- and high-risk groups. Surgery alone of early stage primary tumours might be adequate when stromal FN is negative. Aggressive treatments should be considered when both TNC and FN are abundant.
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Xu Y, Li Z, Jiang P, Wu G, Chen K, Zhang X, Li X. The co-expression of MMP-9 and Tenascin-C is significantly associated with the progression and prognosis of pancreatic cancer. Diagn Pathol 2015; 10:211. [PMID: 26652622 PMCID: PMC4676101 DOI: 10.1186/s13000-015-0445-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 11/28/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) and Tenascin-C (TN-C) have been shown to be involved in the metastasis of many tumors. The purpose of this study was to determine the relationship between the co-expression of these two molecules and the clinical prognosis of pancreatic cancer. METHODS We investigated the expression of TN-C and MMP-9 in 103 pancreatic cancer tissues by immunohistochemistry and used statistical analyses to investigate the correlations of individual expression or co-expression of these two molecules with clinicopathological parameters and survival of pancreatic cancer. RESULTS The expression of MMP-9 and TN-C were increased in pancreatic cancer. The co-expression of MMP-9 and TN-C was also detected. The expression of MMP-9 and TN-C were correlated with vascular invasion, lymph node invasion, liver metastases and TNM stage. The co-expression of MMP-9 and TN-C was significantly related to the pancreatic cancer metastases. The individual overexpression of MMP-9 or TN-C significantly decreased the overall survival rates. The co-expression of MMP-9 and TN-C had the lowest overall survival rates. The co-expression of MMP-9 and TN-C was an independent predictor of survival for pancreatic cancer patients. CONCLUSIONS Co-expression of MMP-9 and TN-C was associated with poorer prognosis and was found to be an independent predictor of survival.
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Affiliation(s)
- Yingqiang Xu
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Zhonghu Li
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Peng Jiang
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Guo Wu
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Kai Chen
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Xi Zhang
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Xiaowu Li
- Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China. .,, No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
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Erstad DJ, Cusack JC. Mutational analysis of merkel cell carcinoma. Cancers (Basel) 2014; 6:2116-36. [PMID: 25329450 PMCID: PMC4276959 DOI: 10.3390/cancers6042116] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/15/2014] [Accepted: 09/24/2014] [Indexed: 12/11/2022] Open
Abstract
Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine malignancy that is associated with a poor prognosis. The pathogenesis of MCC is not well understood, and despite a recent plethora of mutational analyses, we have yet to find a set of signature mutations implicated in the majority of cases. Mutations, including TP53, Retinoblastoma and PIK3CA, have been documented in subsets of patients. Other mechanisms are also likely at play, including infection with the Merkel cell polyomavirus in a subset of patients, dysregulated immune surveillance, epigenetic alterations, aberrant protein expression, posttranslational modifications and microRNAs. In this review, we summarize what is known about MCC genetic mutations and chromosomal abnormalities, and their clinical significance. We also examine aberrant protein function and microRNA expression, and discuss the therapeutic and prognostic implications of these findings. Multiple clinical trials designed to selectively target overexpressed oncogenes in MCC are currently underway, though most are still in early phases. As we accumulate more molecular data on MCC, we will be better able to understand its pathogenic mechanisms, develop libraries of targeted therapies, and define molecular prognostic signatures to enhance our clinicopathologic knowledge.
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Affiliation(s)
- Derek J Erstad
- Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - James C Cusack
- Division of Surgical Oncology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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A practical update of surgical management of merkel cell carcinoma of the skin. ISRN SURGERY 2013; 2013:850797. [PMID: 23431473 PMCID: PMC3570924 DOI: 10.1155/2013/850797] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/30/2012] [Indexed: 01/08/2023]
Abstract
The role of surgeons in the treatment of Merkel cell carcinoma (MCC) of the skin is reviewed, with respect to diagnosis and treatment. Most of the data in the literature are case reports. Surgery is the mainstay of treatment. A wide local excision, with sentinel node (SLN) biopsy, is the recommended treatment of choice. If SLN is involved, nodal dissection should be performed; unless patient is unfit, then regional radiotherapy can be given. Surgeons should always refer patients for assessment of the need for adjuvant treatments. Adjuvant radiotherapy is well tolerated and effective to minimize recurrence. Adjuvant chemotherapy may be considered for selected node-positive patients, as per National Comprehensive Cancer Network guideline. Data are insufficient to assess whether adjuvant chemotherapy improves survival. Recurrent disease should be treated by complete surgical resection if possible, followed by radiotherapy and possibly chemotherapy. Generally results of multimodality treatment for recurrent disease are better than lesser treatments. Future research should focus on newer chemotherapy and molecular targeted agents in the adjuvant setting and for gross disease.
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Renkonen S, Heikkilä P, Haglund C, Mäkitie AA, Hagström J. Tenascin-C, GLUT-1, and syndecan-2 expression in juvenile nasopharyngeal angiofibroma: Correlations to vessel density and tumor stage. Head Neck 2012; 35:1036-42. [DOI: 10.1002/hed.23083] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2012] [Indexed: 12/16/2022] Open
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Eng TY, Boersma MG, Fuller CD, Goytia V, Jones WE, Joyner M, Nguyen DD. A comprehensive review of the treatment of Merkel cell carcinoma. Am J Clin Oncol 2008; 30:624-36. [PMID: 18091058 DOI: 10.1097/coc.0b013e318142c882] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Merkel cell carcinoma (MCC) is an uncommon but malignant cutaneous neuroendocrine carcinoma with a high incidence of local recurrence, regional lymph node metastases, and subsequent distant metastases. The etiology of MCC remains unknown. It usually occurs in sun-exposed areas in elderly people, many of whom have a history of other synchronous or metachronous sun-associated skin lesions. The outcome for most patients with MCC is generally poor. Surgery is the mainstay of treatment. The role of adjuvant therapy has been debated. However, data from recent development support a multimodality approach, including surgical excision of primary tumor with adequate margins and sentinel lymph node dissection followed by postoperative radiotherapy in most cases, as current choice of practice with better locoregional control and disease-free survival. Patients with regional nodal involvement or advanced disease should undergo nodal dissection followed by adjuvant radiotherapy and, perhaps, systemic platinum-based chemotherapy in most cases.
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Affiliation(s)
- Tony Y Eng
- Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Bichakjian CK, Lowe L, Lao CD, Sandler HM, Bradford CR, Johnson TM, Wong SL. Merkel cell carcinoma: critical review with guidelines for multidisciplinary management. Cancer 2007; 110:1-12. [PMID: 17520670 DOI: 10.1002/cncr.22765] [Citation(s) in RCA: 265] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Merkel cell carcinoma (MCC) is a relatively rare cutaneous malignancy that occurs predominantly in the older white population. The incidence of MCC appears to have tripled during the past 20 years; an increase that is likely to continue because of the growing number of older Americans. The pathogenesis of MCC remains largely unknown. However, ultraviolet radiation and immunosuppression are likely to play a significant pathogenetic role. Many questions currently remain unanswered regarding the biologic behavior and optimal treatment of MCC. Large, prospective, randomized studies are not available and are unlikely to be performed because of the rarity of the disease. The objective of this review was to provide a comprehensive reference for MCC based on a critical evaluation of the current data. The authors investigated the importance of sentinel lymph node biopsy as a staging tool for MCC to assess the status of the regional lymph node basin and to determine the need for additional therapy to the lymph node basin. In an attempt to standardize prospective data collection with the intention to define prognostic indicators, the authors also present histopathologic profiles for primary MCC and sentinel lymph nodes. The controversies regarding the appropriate surgical approach to primary MCC, the use of adjuvant radiation therapy, and the effectiveness of adjuvant chemotherapy were examined critically. Finally, the authors have provided treatment guidelines based on the available evidence and their multidisciplinary experience.
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Affiliation(s)
- Christopher K Bichakjian
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan 48109-0314, USA.
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Dang C, Gottschling M, Roewert J, Forschner T, Stockfleth E, Nindl I. Tenascin-C patterns and splice variants in actinic keratosis and cutaneous squamous cell carcinoma. Br J Dermatol 2007; 155:763-70. [PMID: 16965426 DOI: 10.1111/j.1365-2133.2006.07401.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Tenascin-C (Tn-C) is an extracellular matrix protein with multiple functions that is present at low levels in normal tissues, but which is highly present in various tumours. The mRNA expression and protein level of Tn-C including its various isoforms have not been investigated comprehensively so far in cutaneous squamous cell carcinoma (SCC) and the precursor lesion actinic keratosis (AK). OBJECTIVES To assess the dysregulated expression and splice variants of Tn-C in cutaneous squamous cell dysplasia and carcinoma. METHODS Biopsies from 66 patients (or representative subsets) that comprised 25 specimens from normal skin, 19 AK and 22 cutaneous SCC were analysed for Tn-C splice variants using splice-specific primers. The amount of Tn-C mRNA was investigated by quantitative real-time reverse transcription-polymerase chain reaction. In addition, the presence of Tn-C protein was analysed in sections of paraffin-embedded tissues using immunohistochemistry. RESULTS The large Tn-C splice variant was present in only 5% of normal skin samples, in comparison with 63% of AK (P < 0.001) and 88% of SCC (P < 0.001). Tn-C mRNA expression was significantly increased in AK and SCC compared with normal skin (P < 0.001). The corresponding proteins were rarely detected in cells of the vascular epithelial layers and perifollicular layers of some normal skin specimens, and their spatial localization expanded into the papillary dermis of AK. The largest amount and the widest distribution were found in samples of SCC, in which Tn-C was located in the basal cells at the tumour invasion front and additionally in the papillary dermis and reticular dermis. CONCLUSIONS Tn-C is present in the dermis, its expression is increased during skin cancer development, and the large splice variant is characteristic for AK and SCC, which may prove useful for diagnostic approaches in cutaneous SCC.
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Affiliation(s)
- C Dang
- Department of Dermatology, Charité, Skin Cancer Center Charité, University Hospital of Berlin, Berlin, Germany
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Koljonen V, Böhling T, Tukiainen E, Haglund C, Jahkola T. Tenascin-C expression in Merkel cell carcinoma lymph node metastasis. APMIS 2006; 114:39-42. [PMID: 16499659 DOI: 10.1111/j.1600-0463.2006.apm_249.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Expression of tenascin-C (Tn-C) has been shown to correlate with invasion and metastasis in Merkel cell carcinoma (MCC). Cytokeratin-20 (CK-20) is used in differential diagnostics of the primary tumour. The aim of this study was to demonstrate the expression of Tn-C in MCC lymph node metastases. Immunohistochemical staining was performed for five metastatic lymph nodes using a monoclonal antibody against Tn-C and CK-20. All five metastatic lymph nodes expressed Tn-C. The expression concentrated around the vascular structures, invasion borders and fibrotic septae. One of the metastatic lymph nodes was strongly positive for CK-20 while the others showed a focal or negative pattern. The normal lymphoid tissue was negative for Tn-C. Tn-C detected metastatic MCC tissue within the lymph nodes undisputedly. There was a clear distinction between the metastatic and normal lymphatic tissue. Furthermore, invasion to the surrounding tissue was easily demonstrated. Contrary to previous studies, CK-20 expression seemed to fluctuate.
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Affiliation(s)
- Virve Koljonen
- Department of Plastic Surgery, Helsinki University Hospital, Finland.
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