Androgen receptor and 5 alpha-reductase immunohistochemical profiles in extramammary Paget disease

作者：Kasashima S^*; Ozaki S; Kawashima A; Zen Y; Moriya T; Inoue M

来源：British Journal of Dermatology, 2010, 162(5): 1098-1102.

DOI：10.1111/j.1365-2133.2009.09603.x

• androgen
• autocrine synthesis
• invasion
• sex characteristics
• sex steroid-producing enzyme

P>Background
Extramammary Paget disease is an uncommon skin tumour occurring mostly in the genitoperineal region. Previous reports have shown frequent expression of androgen receptor, suggesting a tumour-proliferative effect of androgens on Paget cells. Androgen-converting enzymes such as 5 alpha-reductase, which locally produces a bioactive androgen, have recently gained attention in studies of the intratumoral actions of androgens.
Objectives
We investigated correlations between the androgenic microenvironment and invasiveness in extramammary Paget disease, particularly in terms of sex differences.
Methods
We examined 58 cases of extramammary Paget disease (32 men, 26 women; 42 noninvasive, 16 invasive) using immunohistochemistry for androgen receptor and 5 alpha-reductase.
Results
In all 58 cases, expression rates were 57% for androgen receptor and 55% for 5 alpha-reductase, with 38% double-positivity for androgen receptor and 5 alpha-reductase. Only 5 alpha-reductase expression rate was significantly higher in invasive cases (81%) than in noninvasive cases (45%; P = 0 center dot 042). For invasive cases, numbers of double-positive results for androgen receptor and 5 alpha-reductase were significantly higher in men (70%) than in women (17%; P = 0 center dot 039).
Conclusions
Double positivity for androgen receptor and 5 alpha-reductase in Paget cells suggests autocrine synthesis of androgens in extramammary Paget disease. The different hormonal microenvironments in male and female cases and intratumoral androgen levels affect the invasiveness of extramammary Paget disease.

• 出版日期2010-5