Ber-EP4-Positive Phenotype Differentiates Actinic Keratosis from Superficial Basal Cell Carcinoma

EpCam is a transmembrane epithelial adhesion molecule present on all non-squamous epithelial cells. It is often overexpressed in certain carcinomas, such as breast and colon, and in dermatology, eg, basal cell carcinoma (BCC). Various monoclonal antibodies have been used to detect EpCam, including BerEP4 and epithelial specific antigen. We compared anti-EpCam clones, BerEP4, and epithelial specific antigen clone VU-1D9. One hundred and twelve lesions were stained with both antibodies. All basal cell carcinomas stained uniformly and strongly positive with both antibodies. Diffuse positive staining was also seen in all trichoepitheliomas and merkel cell carcinomas. Focal positive staining was seen in squamous cell carcinoma and benign sebaceous neoplasms. Clone VU-1D9 was more likely to produce focal positive staining as compared to BerEP4. This focal positive staining of sebaceous neoplasms and squamous cell carcinomas is a potential diagnostic pitfall.

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“…Actinic keratoses included in our study failed to stain for EpCAM with both antibodies studied, which is consistent with previous reports 16,17…”

Section: Discussionsupporting

confidence: 93%

Use of Ber-EP4 and Epithelial Specific Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma

2013

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“…Basal cell carcinoma is the most common cutaneous carcinoma, accounting for nearly 70% of all skin malignancies (7)(8)(9)(10)(11)(12). Although a subset of that tumor type can exhibit aggressive behavior (8), most basal cell carcinomas are cured by conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

Basal cell carcinoma vs basaloid squamous cell carcinoma of the skin: an immunohistochemical reappraisal

Webb

Mentrikoski

Verduin

et al. 2015

Annals of Diagnostic Pathology

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“…Thus, the theory that BCCs arise from epithelial germ cells including some identified in vellous hairs could be supported 25 . SCCs have been negative for Ber‐EP4, and therefore, it has been suggested that this antibody could be utilized in the distinction of basal cell from SCC and actinic keratosis in occasions where there is such difficulty 26,36 . Additionally, this antibody has been used successfully in Mohs micrographic surgery when BCC nests are masked by inflammation 37 …”

Section: Discussionmentioning

confidence: 99%

An unusual ostensible example of intraoral basal cell carcinoma

et al. 2009

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An example of oral basal cell carcinoma is presented originating on the posterior mandibular mucosa and gingiva of a 67-year-old female. Histologically, it featured a multifocal pattern. It recurred eight times in a period of 20 years. Tissue samples of the tumor were evaluated with monoclonal antibody Ber-EP4 and were compared with examples of oral mucosa, skin, oral and cutaneous squamous cell carcinoma, peripheral ameloblastoma, ameloblastoma and cutaneous basal cell carcinoma (BCC). Only neoplastic basal cells showed positive immunohistochemical staining. Additionally, microdissected neoplastic areas were evaluated for loss of heterozygosity (LOH) of the PTCH gene with markers D9S303, D9S252 and D9S287. PTCH gene mutations are reported in patients with Gorlin syndrome and sporadic cutaneous BCCs. Loss of one allele was observed with all three markers. Examples of conventional ameloblastomas did not show evidence of LOH. These observations support the inclusion of BCC in the differential diagnosis of appropriate oral mucosal neoplasms.

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Ber-EP4-Positive Phenotype Differentiates Actinic Keratosis from Superficial Basal Cell Carcinoma

Abstract: Ber-EP4 staining reliably distinguishes AK from superficial BCC. The lack of Ber-EP4 staining of AK supports the currently accepted pathogenetic dogma that SIN and SCC arise from AK, but BCC does not.

Cited by 25 publications

References 27 publications

Use of Ber-EP4 and Epithelial Specific Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma

Use of Ber-EP4 and Epithelial Specific Antigen to Differentiate Clinical Simulators of Basal Cell Carcinoma

Basal cell carcinoma vs basaloid squamous cell carcinoma of the skin: an immunohistochemical reappraisal

An unusual ostensible example of intraoral basal cell carcinoma

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