title: p16 immunostaining in keratinocytic neoplasia in organ transplant recipients: Bowen's disease shows a characteristic pattern.
abstract: BACKGROUND
  For selecting therapy, it is important to distinguish different types of keratinocytic neoplasia. It is sometimes difficult to make histopathologic diagnosis, especially in organ transplant recipients (OTR) who develop numerous lesions.
  
  
  METHODS
  To investigate p16 immunostaining in different types of keratinocytic neoplasia in OTR, we studied 59 actinic keratoses (AK), 51 Bowen' s disease (BD), 63 squamous cell carcinomas (SCC), 16 benign keratotic lesions (BKL) from 31 OTR patients and 25 controls (eczema and psoriasis). Tissue sections were stained for H&E and p16. We scored intensity, proportion and distribution of p16 positive lesional cells.
  
  
  RESULTS
  In 19% of AK, 92% of BD, 35% of SCC and 12% of BKL more than 15% of lesional cells were p16-positive. In 16% of AK, 80% of BD, 18% of SCC and 13% of BKL strong p16 staining was observed. BKL, AK and SCC showed focal and patchy staining, BD showed diffuse pattern with strong staining of all atypical cells. Sparing of the basal layer was predominantly seen in BD. No control specimen showed p16-overexpression.
  
  
  CONCLUSIONS
  p16 immunostaining shows a characteristic pattern in BD, but not in AK, SCC and BKL. It appears useful in recognizing BD, but not in differentiating between other keratinocytic neoplasia.
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.|Department of Dermatology, Roosevelt Clinics, Leiden, The Netherlands.
authors.forename: Roel E
authors.initials: RE
authors.lastname: Genders
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, the Netherlands.
authors.forename: Samuel
authors.initials: S
authors.lastname: Beck
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jan Nico
authors.initials: JN
authors.lastname: Bouwes Bavinck
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, the Netherlands.
authors.forename: Henk A M
authors.initials: HA
authors.lastname: van den Munckhof
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Stijn T P
authors.initials: ST
authors.lastname: Kouwenhoven
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, the Netherlands.
authors.forename: Maurits N C
authors.initials: MN
authors.lastname: de Koning
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Frank R
authors.initials: FR
authors.lastname: de Gruijl
authors.affiliation: DDL Diagnostic Laboratory, Rijswijk, the Netherlands.
authors.forename: David
authors.initials: D
authors.lastname: Jenkins
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Rein
authors.initials: R
authors.lastname: Willemze
authors.affiliation: Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.|Department of Dermatology, Roosevelt Clinics, Leiden, The Netherlands.
authors.forename: Koen D
authors.initials: KD
authors.lastname: Quint
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001913:Bowen's Disease / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D055623:Keratosis, Actinic / Q000175:diagnosis; D012878:Skin Neoplasms / Q000175:diagnosis*; D066027:Transplant Recipients
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: Bowen's disease; actinic keratosis; keratinocytic neoplasia; p16; squamous cell carcinoma