ORL
ro
situ carcinoma we noticed signifi-
Table 1
cant decrease of intraepithelial posi-
The relation between lesion type, tumour and peritumour area S100
tive cells numbers (mean 9/field x
400) and their absence in perilesion
protein positive cells and lymph inflammatory infiltrate
stroma ( fig.2c). In cases of squamous
cell carcinoma, the highest numbers
lymph
of S100 protein positive cells were no-
lesion
S100+ in tumour S100+ in peritu-
area mour area
inflammatory
ticed in tumour islands ( fig.2d), and
infiltrate index
in parakeratosic and keratosic pearls
leucoplasia
( fig.2e) of well differentiated cases. (n = 3)
12.66 7.33 1.66
In cases of undifferentiated squa-
adenoid cell
mous cell carcinoma positive cells
carcinoma (n = 1)
0 0 0
were rare (mean 5.6/field in tumour
in situ carcinoma (n = 1) 9 0 2
area), small in dimensions with short
and less dendritiform cytoplasm ex- G1 (n = 12) 31.5 4.75 1.5
tensions. The relation between posi-
SCC
tive cell density and degree of dif-
(n = 44)
G2 (n = 24) 14.75 7.66 1.5
ferentiation was noticed in G2 areas,
G3 (n = 8) 5.6 8.55 1.66
being numerous, and G3 area – rare
or absent. These data suggests posi-
tive cells indirect value in squamous molecules and presents the antigen CD40/CD40L). MHC class II peptides
cell carcinoma grading. in this context to T-cells, including are expressed on the surface of pro-
In cases of squamous cell carcino- macrophages, endothelium, dendrit- fessional antigen-presenting cells
ma we encountered an inverse cor- ic cells and Langerhans cells of the (APCs). Common APCs in the body
relation between peritumour stroma skin (14). include macrophages, B lympho-
and tumour islands S100 protein cell Mast cells accumulate around cytes, bone-marrow-derived dendrit-
density. Stroma positive cells were cutaneous malignancies. Current ic cells, Langerhans cells of the skin,
rare in well differentiate carcinoma, evidence suggests that mast cells and human endothelial cells (18).
and numerous in poor differentiate contribute to the tumorigenesis Toriyama K et all. (19) examined
carcinoma (4.75 versus 8.55). Those of cutaneous malignancies by four the frequency, distribution, and im-
cells presented less evident dendrite mechanisms: immunosuppression, munophenotype (S-100 protein, CD1)
morphology, being isolate disposed angiogenesis: mast cells are the ma- of epidermal Langerhans cells (LC)
( fig.3a) and in some cases the cells jor source of vascular endothelial in the epidermis overlying primary
were present in large groups in peri- growth factor in basal cell carcinoma melanoma, and dermal dendritic
tumour area ( fig.3b). The presence and malignant melanoma; vascular cells (DC) in the dermis deep to mel-
of lymph inflammatory infiltrate was endothelial growth factor is one of anoma, and in adjacent normal skin.
constantly associated with increased the most potent angiogenic factors, There is a substantial reduction in
number of positive cells. Positive cells degradation of extracellular matrix: S100+ LC and a lesser decline in CD1+
were absent in the necroses and gran- through its own proteases, and indi- LC in the epidermis over melanoma.
ulocyte infiltrate area in all cases. The rectly via interaction with other cells, There is a simultaneous increase
relation between lesion type, tumour mast cells participate in degradation in the frequency of cells expressing
and peritumour area S100 protein of the matrix, which is required for tu- these phenotypes in the dermis deep
positive cells and lymph inflammatory mor spread and mitogenesis (15, 16). to tumour. Double-staining studies in
infiltrate is presented in Table 1. It is now evident that T-lymphocyte- progress showed coexpression of S-100
Because S100 protein is not a high mediated cellular responses play a and CD1 in most of these cells. The
specific APC marker, corresponding critical role in the body’s ability to gen- depletion of S-100+/CD1+ DC from the
sections from each case were CD68 erate an antitumor immune response. peritumoral epidermis is maximum in
immunohistochemical stained. We en- The generation of an effective and deeper (Clark level III-V) and thicker
countered a small number of macro- specific T-cell-mediated immune re- (> 0.76 mm) tumors. The reduction in
phages, with oval or polygonal shape, sponse requires the activation of both total DC in peritumoral epidermis is,
short and unramified, with rare exten- cytotoxic (CD8+) and helper (CD4+) T- however, proportionally less than the
sions. Comparing these 2 methods we lymphocyte subsets (17). reduction in S-100+/CD1+ DC owing
encountered APC being the majority To activate a CD4+ T-cell response, to an increase in cells that are S-100-/
of S100 protein positive cells. antigens must be presented to CD4+ CD1+. The proportion of S-100+/CD1+
T cells in conjunction with a major dermal DC deep to tumour is similar to
Discussions histocompatibility complex (MHC) that in normal epidermis and dermis,
Antigen presenting cell represent a class II peptide. This is done in the suggesting that there is no increased
cell that carries on its surface anti- presence of a number of co-stimu- migration of S-100-/CD1+ DC from tu-
gen bound to MCH Class I or Class II latory molecules (eg, CD28/B7 and mour-associated epidermis to subjacent
Nr. 2/februarie 2009
pag. 31
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