title: Cell proliferation in skin tumors with ductal differentiation: patterns and diagnostic applications.
abstract: The kinetic features of skin tumors with ductal differentiation (TDD) remain mainly unknown. We selected 88 skin TDD (D-PAS-positive cuticles) classified according to Murphy and Elder's criteria. Tumors studied included 13 poromas, 12 nodular hidradenomas, 10 cylindromas, 6 spiradenomas, 9 syringomas, 9 chondroid syringomas, 7 porocarcinomas, 15 malignant nodular hidradenomas, and 7 not otherwise specified carcinomas. The same tumor areas were evaluated for mitotic figure counting (MFC) and proliferation rate (PR = MIB-1 index), screening 10 consecutive high-power fields (HPFs) in the most cellular areas. Results were recorded by HPF and tumor cellularity, considering both average and standard deviation. Differences were analyzed by Student's t-test and analysis of variance (ANOVA) and considered significant if p<0.05. PR was significantly higher in malignant (23.29 +/- 12.49) than in benign tumors (3.86 +/- 4.44) and in poromanodular hidradenoma (4.99 +/- 3.34) than in spiradenoma-cylindroma-syringoma (1.91 +/- 1.67), but not by malignant tumor type. MFC was significantly higher in malignant (25.52 +/- 4.10) than in benign tumors (1.57 +/- 0.38), showing porocarcinomas the biggest MFC/10 HPF and malignant nodular hidradenomas the highest MFC/1000 cells. PR and MFC are useful malignancy criteria in skin TDD and should be evaluated by tumor cellularity to avoid potential misinterpretations related with tumor heterogeneity.
authors.affiliation: Department of Dermatology, The Royal London Hospital, UK.
authors.forename: L
authors.initials: L
authors.lastname: Pozo
authors.forename: F
authors.initials: F
authors.lastname: Camacho
authors.forename: J J
authors.initials: JJ
authors.lastname: Rios-Martin
authors.forename: S J
authors.initials: SJ
authors.lastname: Diaz-Cano
mesh_terms: D018250:Acrospiroma / Q000737:chemistry / Q000473:pathology*; D006607:Adenoma, Sweat Gland / Q000737:chemistry / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D034961:Antigens, Nuclear; D002455:Cell Division; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009687:Nuclear Proteins / Q000032:analysis; D013544:Sweat Gland Neoplasms / Q000737:chemistry / Q000473:pathology*; D018252:Syringoma / Q000737:chemistry / Q000473:pathology*
chemical_list: D000911:Antibodies, Monoclonal; D034961:Antigens, Nuclear; D019394:Ki-67 Antigen; D009687:Nuclear Proteins