NEW WORK ON PODOPLANIN IN J. AM. AC. DERMATOLOGY

J Am Acad Dermatol. 2012 Apr 19. [Epub ahead of print]

D2-40 immunohistochemical overexpression in cutaneous squamous cell carcinomas: A marker of metastatic risk.

Toll A, Gimeno-Beltrán J, Ferrandiz-Pulido C, Masferrer E, Yébenes M, Jucglà A, Abal L, Martí RM, Sanmartín O, Baró T, Casado B, Gandarillas A, Barranco C, Costa I, Mojal S, García-Patos V, Pujol RM.

Source

Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.

Abstract

BACKGROUND:

Approximately 4% of cutaneous squamous cell carcinomas (cSCCs) develop lymphatic metastases. The value of lymphatic endothelial markers to enhance the detection of lymphatic tumor invasion in cSCC has not been assessed previously.

OBJECTIVE:

We sought to evaluate the use of the antibody D2-40, a podoplanin immunohistochemical marker, to identify tumor lymph vessel invasion in cSCC and to assess its expression in tumor cells.

METHODS:

A skin carcinoma section

This was a retrospective case-control study. A series of 101 cSCC, including 51 cases that developed lymphatic metastatic spread (metastasizing cSCC [MSCC]) and 50 cases that resolved definitely after surgical excision (non-MSCC) were included in the study. Lymph vessel invasion using D2-40 was evaluated on all primary biopsy specimens. The percentage of tumor cells showing D2-40 positivity and intensity scoring were recorded. All the immunohistochemical findings were correlated with the clinicopathological features.

RESULTS:

Lymph vessel invasion was observed in 8% of non-MSCCs and in 25.5% of MSCCs (P = .031). D2-40 expression was significantly increased, both in intensity (odds ratio 4.42 for intensity ++/+++) and in area (odds ratio 2.29 for area >10%), in MSCC when compared with non-MSCC. Interestingly, almost half (49%) of the MSCC had moderate to intense D2-40 positivity compared with 16% of non-MSCC. D2-40 immunohistochemical expression was increased in tumors with an infiltrative pattern of extension. In the multivariate analysis, histologically poorly differentiated tumors, recurrent lesions, and cSCC showing D2-40 overexpression (in intensity) were significantly associated with lymphatic metastases development (odds ratios 15.67, 14.72, and 6.07, respectively).

LIMITATIONS:

This was a retrospective study.

CONCLUSION:

The expression of podoplanin associates with high metastatic risk in cSCC.

Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.