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Minichromosome Maintenance Protein Expression According to the Grade of Atypism in Actinic Keratosis

Shin, Jung Won MD; Kim, Yeon Kyung; Cho, Kwang Hyun MD, PhD

The American Journal of Dermatopathology: December 2010 - Volume 32 - Issue 8 - p 794-798
doi: 10.1097/DAD.0b013e3181de4e93
Original Study

The minichromosome maintenance (MCM) family is agroup of proteins that are key initiation factors for DNA replication and are expressed only in cycling cells. Recent studies on various cancerous conditions have shown that MCM proteins are better markers for malignant cells compared to other proliferative markers. It has been also proven that MCM proteins are independent prognostic factors. The aim of this study was to characterize the pattern and frequency of MCM 2 protein expression in actinic keratosis (AK) and determine whether the expression is correlated with the degree of histological atypism. Biopsy samples of 34 patients who had been diagnosed as AK were used in this study. Samples were divided into three groups (grade I, grade II, and grade III) according to the degree of atypism. Immunohistochemical staining for MCM 2 protein, Ki-67, and proliferating cell nuclear antigen was performed, and the number of positively staining cells per unit area (10−4 μm2) was calculated for evaluation of immunoreactivity. MCM 2 protein was expressed in atypical keratinocytes in AK. Mean numbers of immunoreactive cells positive for MCM 2 were 165.1 in grade I, 304.5 in grade II, and 513.3 in grade III. Moreover, the correlation between the immunoreactivity for MCM 2 protein and AK grade was significantly more positive than that for other markers. Thus, we suggest that MCM 2 protein is a reliable marker for diagnosing and grading AK and further could be hypothesized as an important prognostic factor.

From the Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.

Reprints: Kwang Hyun Cho, MD, PhD, Department of Dermatology, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.