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Inflammatory markers, oncogenes, tumor suppressor genes and cell
cycle regulators in skin growths represent a series of reports and
reviews on skin cancers and precancers, their host immune responses
and correlations with medical literature data. We were able to
clearly identify an immune response in multiple skin cancers, as
well as in cutaneous pre-cancerous conditions. In poorly
differentiated tumor areas, some classic immunohistochemical stains
did not stain as frequently described in the literature. Other
important phenomena we observed are that many cell cycle
regulators, cell cycle checkpoints, oncogenes and tumor suppressor
gene markers were not only positive inside the tumors, but also in
cells around the tumor. Portions of adjacent skin appendices and in
supposedly normal adjacent epidermal and dermal tissue also showed
signs of these components. These common findings raised questions
concerning marginal definition of cutaneous surgery; that is, many
of the immunologic findings could not be correlated on classical
hematoxylin and eosin reviews. We also noted that many immunologic
cells around skin cancers and/or pre-cancers showed high rates of
division defined via markers such as Ki-67; our findings utilizing
double color immunohistochemistry also showed that these immune
cells are possibly actively duplicating as effector cells. Ki-67
has been cited as a superb proliferation marker in melanoma, but
additional review of its utility is warranted given our results.
Finally, we also found double staining immunohistochemistry to be
of excellent value in detecting melanoma cells metastasizing in
blood vessels, lymphatics and/or nerves.
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