The utility of ATF3 in distinguishing cutaneous squamous cell carcinoma among other cutaneous epithelial neoplasms

Authors

  • Crystal L. Rose,

    Corresponding author
    1. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    • Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Nitin Chakravarti,

    1. Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Jonathan L. Curry,

    1. Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Carlos A. Torres-Cabala,

    1. Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Roland Bassett,

    1. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Victor G. Prieto,

    1. Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author
  • Michael T. Tetzlaff

    1. Department of Pathology, Section of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Search for more papers by this author

  • These authors contributed equally to this work

Michael T. Tetzlaff, MD, PhD,

Department of Pathology,

Section of Dermatopathology,

The University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd, Unit 85,

Houston, TX 77005, USA

Tel: +713 792 2585

Fax: +713 745 0778

e-mail: mtetzlaff@mdanderson.org

Abstract

The histopathologic distinction between benign and malignant cutaneous keratinocytic proliferations can pose a difficult diagnostic challenge – often with important clinical implications. Activating transcription factor 3 (ATF3) has emerged as a potential biomarker which may aid in the segregation of these lesions, and we hypothesize that ATF3 expression may be a specific marker of cutaneous squamous cell carcinoma (SCC). Using immunohistochemistry, we characterized ATF3 expression in a series of 126 cutaneous epithelial proliferations, including SCC (n = 27), basal cell carcinomas (BCC, n = 59), seborrheic keratoses with atypia (SK, n = 16), hyperplastic actinic keratoses (AK, n = 12) and prurigo nodularis cases (PN, n = 12). We showed strong, nuclear and/or nucleolar expression of ATF3 in a statistically significant number of cases of SCC compared to BCC, SK and PN. We conclude that ATF3 expression is a surrogate of malignancy (or pre-malignancy) in keratinocytic epithelial proliferations and thus helps distinguish SCC from other cutaneous epithelial neoplasms.

Ancillary