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J.P. Fernandez-Suntay, T.P. Dryja; Immunohistochemical Profiles of Sebaceous, Squamous and Basal Cell Carcinoma using Antibodies to Epithelial Membrane Antigen (EMA) and Anti-cytokeratin (CAM 5.2) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2431.
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Purpose: To evaluate the usefulness of the immunohistochemical markers EMA and CAM 5.2 to differentiate sebaceous cell carcinoma, squamous cell carcinoma, and basal cell carcinoma arising from the ocular adnexa including the eyelids. Methods: Paraffin-embedded specimens of 17 sebaceous, 14 squamous, and 19 basal cell carcinomas from the eyelids or orbit were obtained from the files of the Cogan Eye Pathology Laboratory. We included all sebaceous and squamous carcinomas accessioned between August, 2001 and November, 2002, for which residual material was available. A subset of basal cell carcinomas from this period was randomly selected. Only one specimen per patient was evaluated (recurrences were not counted). Representative sections from each case were made and evaluated with the immunohistochemical markers EMA and CAM 5.2. Immunohistochemical stains were scored as negative when no definite staining was found in any tumor cells. If a tumor stained focally or diffusely, it was classified as positive. Results: Of the 50 cases that we ascertained, sufficient material to perform this study was available on 25 (9 sebaceous cell carcinomas, 8 squamous cell carcinomas, and 8 basal cells carcinomas). Expression of EMA was frequent in sebaceous cell carcinomas (7/9 cases were positive) and squamous cell carcinomas (8/8 cases) but not basal cell carcinomas (1/8 cases). On the other hand, expression of CAM 5.2 was found frequently in basal cell carcinomas (7/8) but less frequently in sebaceous cell carcinomas (3/9) or squamous cell carcinomas (2/8). Conclusions: EMA and Cam 5.2 appear to be helpful in distinguishing sebaceous and squamous cell carcinomas from basal cell carcinomas. However, these markers do not appear to be useful in distinguishing sebaceous from squamous cell carcinomas. Our findings contrast with those of Sinard (Arch Ophthalmol.,117, 776-783, 1999), who found CAM 5.2 reactivity in most sebaceous carcinomas (8/11) but not in squamous cell carcinomas (0/14).
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