Dermatofibrosarcoma protuberans: A retrospective study of clinicopathologic features and related Akt/mTOR, STAT3, ERK, cyclin D1, and PD-L1 expression - 06/09/18

Doi : 10.1016/j.jaad.2018.05.016

Sunyoung Park, MD, MS ^a, Soyun Cho, MD, PhD ^b, Minji Kim, MD, PhD ^b, Ji Ung Park, MD, PhD ^c, Eui Cheol Jeong, MD, PhD ^c, Euno Choi, MD, MS ^a, Jeong Hwan Park, MD, PhD ^a, Cheol Lee, MD, PhD ^d, Mee Soo Chang, MD, PhD ^a,^⁎
^a Department of Pathology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
^b Department of Dermatology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
^c Department of Plastic and Reconstructive Surgery, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
^d Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea

^∗Reprint requests: Mee Soo Chang, MD, PhD, Department of Pathology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea.Department of PathologySeoul National University Boramae HospitalSeoul National University College of Medicine20 Boramae-ro 5-gil, Dongjak-guSeoul07061Korea

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 06 September 2018
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Background

Little is known regarding oncoproteins other than platelet-derived growth factor subunit B in dermatofibrosarcoma protuberans (DFSP). Moreover, the risk factors for worse prognosis are controversial.

Objective

We sought to determine the clinicopathologic features and key factors for adverse outcome in DFSP, including the implication of expression of protein kinase B (Akt)/mammalian target of rapamycin (mTOR), signal transducer and activator of transcription 3 (STAT3), extracellular signal regulated kinase (ERK), cyclin D1, and programmed death ligand 1 (PD-L1).

Methods

Clinicopathologic and immunohistochemical analyses were performed for 44 DFSPs having wide local excision and 92 dermatofibromas as controls.

Results

Compared with the 35 nonrecurrent DFSPs, the 9 recurrent DFSPs exhibited larger tumor size, deeper invasion beyond the subcutis, and more diverse histologic subtype. The fibrosarcomatous subtype revealed frequent mitotic figures and a high cyclin D1–positive index. The 2 metastatic DFSPs (1 each of the fibrosarcomatous and myxoid subtypes) demonstrated 4 and 11 instances of local recurrence, respectively, as well as larger tumor size, deeper invasion beyond the subcutis, and high expression of cyclin D1. Expression of Akt/mTOR, STAT3, ERK, and PD-L1 ranged from none or low in the primary skin lesions to high in the corresponding metastatic sites. Akt/mTOR and ERK were expressed more frequently in DFSP than in dermatofibroma.

Limitations

Lack of information on patients before hospital evaluation.

Conclusion

Complex factors beyond fibrosarcomatous subtype may portend local recurrence or metastasis. Akt/mTOR, STAT3, ERK, and PD-L1 may be associated with development and/or progression of DFSP.

Le texte complet de cet article est disponible en PDF.

Key words : Akt, cyclin D1, dermatofibrosarcoma protuberans, ERK, metastasis, mTOR, PD-L1, recurrence, STAT3

Abbreviation used : DFSP

Plan

Clinicopathologic features and patient outcome

Protein expression in DFSP

Discussion

Conclusions

	Funding sources: Supported by the Basic Science Research Program of the National Research Foundation of Korea, which is funded by the Ministry of Education (grant 2016R1D1A1B01010316).
	Conflicts of interest: None disclosed.
	Accepted for publication May 8, 2018.