Expression of survivin and human telomerase reverse transcriptase in extramammary Paget's disease.
BACKGROUND
Extramammary Paget's disease (EMPD) is a rare neoplasm of apocrine gland-bearing skin. It is known that over-expression of survivin and human telomerase reverse transcriptase (hTERT) correlates with malignancies. We investigated the expression of hTERT and survivin by Paget's cells and their role in the tissue invasion and recurrence of EMPD.


METHODS
Forty-two patients were enrolled into the study. Expression of survivin and hTERT were analyzed by immunohistochemistry and in situ hybridization techniques. The variables including the expression level of survivin and hTERT, gender, age, lesion location, invasion level and number of surgeries were statistically analyzed using Fisher's exact test.


RESULTS
Survivin was positively stained in 18 of 22 cases (81.8%), and hTERT in 18 of 29 cases (62.1%). Significantly higher level of survivin expression was detected in patients with multiple surgeries than those with single one (p = 0.0458). Expression of hTERT was significantly higher in the patients with micro-invasive and invasive lesions than those with non-invasive lesions (p = 0.0478).


CONCLUSIONS
Over-expression of survivin and hTERT correlated strongly with recurrence and local invasion of EMPD lesions. EMPD has male gender predominance in Oriental population.
Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang 110001, China.
Shi-Jun
SJ
Shan
Naiqin
N
Zhang
Shi-Ling
SL
Geng
Zhihai
Z
Zhou
Xu
X
Chen
Tingfen
T
Nie
Zhe
Z
Guo
Changping
C
Li
Quanzhong
Q
Liu
Ying
Y
Guo
Huachen
H
Wei
Hong-Duo
HD
Chen
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000235:genetics / Q000378:metabolism*; D010413:Penis / Q000378:metabolism; D012611:Scrotum / Q000378:metabolism; D012737:Sex Factors; D012867:Skin / Q000378:metabolism*; D012878:Skin Neoplasms / Q000235:genetics / Q000378:metabolism*; D000077022:Survivin; D019098:Telomerase / Q000235:genetics / Q000378:metabolism*; D014844:Vulva / Q000378:metabolism
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D000077022:Survivin; D019098:Telomerase