title: Glut-1 expression and in situ CD1a/CD57 immunologic deficit in keratoacanthoma and squamous cell carcinoma of immunocompetent patients.
abstract: It is not easy to reach a differential diagnosis between keratoacanthoma (KA) and squamous cell carcinoma (SCC) and furthermore there is still considerable discussion about the relationship of these 2 tumors with immunity. To facilitate such a diagnosis, we assessed the Glut-1 antibody, reported to be strongly and diffusely expressed in SCC but never assessed in KA. We studied 43 lesions of immunocompetent patients: 17 SCCs, 13 typical KAs (tKAs), and 13 atypical KAs (aKAs), with histologic features of SCC in less than 30% of the lesions. In tKA, Glut-1 stained only the basal layers of the squamous nests (basal pattern) whereas in SCC the squamous nests were randomly and diffusely stained (diffuse pattern). In aKA, a biphasic pattern was observed, with the typical KA areas showing the basal pattern and the SCC-like areas showing the diffuse pattern. Glut-1, therefore, helps to distinguish tKAs from SCCs and highlights the intermediate aKA group, supporting the hypothesis of a progression from KA to SCC. Finally, we used CD1a, CD57, CD4, CD8, CD3, and CD20 antibodies to assess whether or not the progression might be related to an in situ immunologic deficit. Significant differences were found both in CD1a+ cells, more numerous in tKA than in SCC and in CD57+ cells, more numerous in tKA than in aKA and in SCC. This suggests a local immunological failure in aKA and SCC, probably related to the action of UV rays, leading us to consider KA as a model for the study of the interaction of skin cancer and immunity.
authors.affiliation: Department of Human Pathology, University of Palermo, Palermo, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cabibi
authors.forename: Francesco
authors.initials: F
authors.lastname: Aragona
authors.forename: Carla
authors.initials: C
authors.lastname: Guarnotta
authors.forename: Vito
authors.initials: V
authors.lastname: Rodolico
authors.forename: Monica
authors.initials: M
authors.lastname: Zerilli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Belmonte
authors.forename: Loredana
authors.initials: L
authors.lastname: Schillaci
authors.forename: Federico
authors.initials: F
authors.lastname: Aragona
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018949:Antigens, CD1 / Q000096:biosynthesis; D014408:Biomarkers, Tumor / Q000378:metabolism; D018959:CD57 Antigens / Q000096:biosynthesis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D018450:Disease Progression; D027342:Excitatory Amino Acid Transporter 2 / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D005260:Female; D006801:Humans; D007109:Immunity; D007636:Keratoacanthoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology
chemical_list: D018949:Antigens, CD1; D014408:Biomarkers, Tumor; C419393:CD1a antigen; D018959:CD57 Antigens; D027342:Excitatory Amino Acid Transporter 2