April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Immunohistochemical Analysis of Sebaceous Cell Carcinoma in Comparison to Both Basal Cell Carcinoma and Squamous Cell Carcinoma
Author Affiliations & Notes
  • Andre Nihad Ali-Ridha
    Department of Ophthalmology, University of Ottawa, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
  • Seymour Brownstein
    Department of Ophthalmology, University of Ottawa, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
  • Kailun Jiang
    Department of Ophthalmology, University of Ottawa, The Ottawa Hospital, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
  • Tatyana Milman
    Departments of Ophthalmology and Pathology, New York Eye and Ear Infirmary, New York, NY
  • Bruce Burns
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
  • Paula Blanco
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
  • James Farmer
    Department of Pathology and Laboratory Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5432. doi:
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      Andre Nihad Ali-Ridha, Seymour Brownstein, Kailun Jiang, Tatyana Milman, Bruce Burns, Paula Blanco, James Farmer; Immunohistochemical Analysis of Sebaceous Cell Carcinoma in Comparison to Both Basal Cell Carcinoma and Squamous Cell Carcinoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5432.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Basal cell carcinoma is the most common malignancy of the eyelid followed by sebaceous cell and squamous cell carcinoma. The mortality rate of sebaceous cell carcinoma has been reported as 9 to 30% and both it and squamous cell carcinoma can develop metastatic disease. Clinically, sebaceous cell carcinoma frequently mimics inflammatory conditions and other neoplasms of the eyelid, including both squamous cell and basal cell carcinoma. Our study compares the immunostaining profile of sebaceous cell carcinoma to that of basal cell and squamous cell carcinoma.

Methods: Retrospective and prospective case series. Eight specimens each of sebaceous cell, basal cell and squamous cell carcinoma of the eyelid were obtained from the Ottawa Ocular Pathology Laboratory from 2007 to 2013. We compared the immunohistochemical profile of these specimens by staining each of them with EMA, BER-EP4, adipophilin, androgen receptor (AR), P16, BCL-2, CK7, Ki67, BRST1, BRST2, p53, and CK20. We compared the extent of staining to that of normal surface and glandular epithelial tissue on each slide as normal internal controls. The immunoreactivity data was then analyzed using a 2-tailed Kruskal-Wallis test (p<0.05 is significant) with a post-hoc analysis using Mann-Whitney tests.

Results: Our test results were statistically significant (p<0.05) for positive staining of EMA, adipophilin, P16 and AR in sebaceous cell carcinoma. This group also showed a higher percentage of positivity for Ki67. The basal cell tumours exhibited positive staining for CK7, BCL2, and BER-EP4, while squamous cell carcinoma showed substantial positivity only for EMA. Adipophilin stained positive in sebaceous cell carcinoma with intracytoplasmic lipid vesicles in 94% of the cells in our series as compared to the nonspecific or minimal staining of granules in basal and squamous carcinoma cells respectively.

Conclusions: Our study helps clarify much of the controversy in the literature concerning immunostains which overlap in reactivity for sebaceous cell carcinoma. We have found that the most informative panel of immunostains, from our original 12 stains, for differentiating sebaceous cell carcinoma from other related tumors consists of P16, adipophilin, EMA, AR, CK7 and Ki67. This diagnostically optimal panel of immunostains may allow for earlier diagnosis and treatment of sebaceous cell carcinoma of the eyelid.

Keywords: 554 immunohistochemistry • 744 tumors • 638 pathology: human  
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