Monoclonal Antibody Ber EP4 Distinguishes Basal-Cell Carcinoma from Squamous-Cell Carcinoma of the Skin

Tellechea, Óscar; Reis, José; Domingues, José Carlos; Baptista, A. Poiares

doi:10.1097/00000372-199310000-00007

Cited by 126 publications

(116 citation statements)

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“…34 The utility of this antibody in distinguishing basal cell carcinoma and squamous cell carcinoma based upon its consistent expression in the former and absence in the latter is well documented. 35,36 While we also found BerEP4 in all cases of infiltrative basal cell carcinoma in our study, we noted strong BerEP4 expression in 38% our microcystic adnexal carcinoma cases. Similar to our study, Smith et al 23 reported BerEP4 immunoreactivity in glandular areas of their 10 cases of microcystic adnexal carcinoma.…”

Section: Discussionsupporting

confidence: 48%

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang

Dresser

Kapur³

et al. 2008

Modern Pathology

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Even though immunohistochemical comparisons of microcystic adnexal carcinoma vs infiltrative basal cell carcinoma and desmoplastic trichoepithelioma exist, they are mostly restricted to the use of a single stain. In addition, a comparison with squamous cell carcinoma has not been reported previously. In this study, we compare the expression of cytokeratin (CK) 15, CK7, CK20, CK903, carcinoembryonic antigen (CEA), CD10, CD15 and BerEP4 in 13 microcystic adnexal carcinoma, eight desmoplastic trichoepithelioma, 10 infiltrative basal cell carcinoma, and eight squamous cell carcinoma of which five exhibited ductal differentiation. We found that the majority of microcystic adnexal carcinoma (92%) and desmoplastic trichoepithelioma (100%) cases expressed CK15 while the infiltrative basal cell carcinoma and squamous cell carcinoma cases were all negative. Forty percent of infiltrative basal cell carcinoma expressed CK7; while only two microcystic adnexal carcinoma cases (15%) and one squamous cell carcinoma with ductal differentiation (12%) expressed CK7 in the remaining three tumor categories. None of the desmoplastic trichoepithelioma expressed CK7. All tumors were strongly positive for CK903. While the neoplastic cells were negative, luminal staining of ductal structures was noted for CK7, CD15 and CEA in some of the microcystic adnexal carcinoma, desmoplastic trichoepithelioma and squamous cell carcinoma with ductal differentiation cases. Sixty percent of infiltrative basal cell carcinoma, 31% of microcystic adnexal carcinoma, and 25% of squamous cell carcinoma express CD10. BerEP4 expression was noted in 38% of microcystic adnexal carcinoma, 57% of desmoplastic trichoepithelioma, 100% of infiltrative basal cell carcinoma, and 38% of squamous cell carcinoma. In conclusion, we found CK15 to be a useful marker in distinguishing microcystic adnexal carcinoma from infiltrative basal cell carcinoma and squamous cell carcinoma with ductal differentiation. Our experience indicates that microcystic adnexal carcinoma and desmoplastic trichoepithelioma have a similar immunohistochemical profile that is, CK15 þ and BerEP4 þ /À; thus, additional studies are needed to separate these two entities.

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Section: Discussionsupporting

confidence: 48%

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang

Dresser

Kapur³

et al. 2008

Modern Pathology

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“…Ber-EP4 is commonly employed to assist in this distinction, with strong expression in BCC and absent expression in squamous cell carcinoma (Table). 81,82 Of note, Ber-EP4 may not be expressed in squamatized areas of BCC, 83 and focal staining with Ber-EP4 has been reported in squamous cell carcinoma. 84 …”

Section: Tumor Of the Follicular Infundibulummentioning

confidence: 99%

Histologic Mimics of Basal Cell Carcinoma

Stanoszek

Wang

Harms

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. Objective.— To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. Data Sources.— Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. Conclusions.— In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.

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“…7 Numerous immunohistochemical stains have been reported to be helpful in distinguishing these entities, perhaps most notably BerEp4. 8 However, BerEp4 fails to stain areas of squamous differentiation, and therefore is most useful in conjunction with other immunostains. 9 Cytokeratin 14 (CK14) and cytokeratin 17 (CK17) have both been reported as positive immunostains for BCC, 10 although CK14 has not been studied in BCCm.…”

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confidence: 99%

BerEp4, Cytokeratin 14, and Cytokeratin 17 Immunohistochemical Staining Aid in Differentiation of Basaloid Squamous Cell Carcinoma From Basal Cell Carcinoma With Squamous Metaplasia

Linskey

Gimbel

Zukerberg

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Basaloid squamous cell carcinoma (bSCC) is an uncommon variant of squamous cell carcinoma, which may overlap histologically with basal cell carcinoma with squamous metaplasia (BCCm).Objective.-To aid in the differentiation of these neoplasms using immunohistochemical staining because of the worse prognosis associated with bSCC.Design. ). An immunoreactivity score was assigned using the percentage of tumor cells staining and the pattern of expression. Interobserver agreement for 2 independent pathologists was assessed using a j coefficient.Results.-The mean percentage of staining was significantly higher in BCCm, compared with bSCC (BerEp4, P ¼ .006; CK17, P , .001; CK14, P , .001; unpaired t test), with 58% of BCCm cases (25 of 43) displaying diffuse staining for all markers, and nearly all (98%; 42 of 43) displaying diffuse staining for CK17 and CK14. In contrast, no bSCC cases (0%) displayed diffuse staining for all 3 markers, and only 8% (2 of 25) displayed diffuse staining for CK17 and CK14. High interobserver agreement was determined.Conclusions.-BerEp4 alone is unreliable for differentiation between BCCm and bSCC, and the addition of either CK14 or CK17 will augment the sensitivity and negative predictive value of BerEp4 staining in BCCm and bSCC diagnosis.

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Monoclonal Antibody Ber EP4 Distinguishes Basal-Cell Carcinoma from Squamous-Cell Carcinoma of the Skin

Cited by 126 publications

References 0 publications

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Histologic Mimics of Basal Cell Carcinoma

BerEp4, Cytokeratin 14, and Cytokeratin 17 Immunohistochemical Staining Aid in Differentiation of Basaloid Squamous Cell Carcinoma From Basal Cell Carcinoma With Squamous Metaplasia

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