{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T04:09:55Z","timestamp":1748664595178,"version":"3.41.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","award":["TYH2020208"],"award-info":[{"award-number":["TYH2020208"]}],"id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec009\">\n<jats:title>Background<\/jats:title>\n<jats:p>Eccrine poroma (EP) and porocarcinoma (EPC) arise from the intraepidermal part of the sweat gland. Clinically they resemble each other and cannot be distinguished without histopathological examination. EPC has been described as aggressive; however, the Ki-67 index is scarcely reported. The aim of this study was to compare clinicopathological factors between EP and EPC with special interest in Ki-67 index.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec010\">\n<jats:title>Methods and Findings<\/jats:title>\n<jats:p>50 EP and 22 EPC samples with clinical data from 48 EP and 21 EPC patients were collected from the Finnish Biobanks. We performed immunohistochemistry using a Ki-67 antibody on a tissue microarray and analysed the Ki-67 index with ImmunoRatio 2.5-program. We analysed 48 EP and 21 EPC samples. EPC patients were older (p\u2009=\u20090.019) and their tumours larger (p\u2009=\u20090.003) but other than these there were no statistically significant differences. Ki-67 ratios were similar (medians: EP 0.6% and EPC 0.5%). The median follow-up time in EP group was 12 (range 1.5\u201330.6 years) and in EPC group 7 years (range 0.75\u201320.3 years). The survival of EP patients was better than EPC patients but did not reach statistical significance and, in the Cox multivariate analysis only age had statistically significant effect (HR 1.061, 95% CI 1.026\u20131.099, p\u2009&lt;\u20090.001). Ki-67 index had no statistically significant effect on survival in EPC group in the Cox univariate analysis (HR 0.746, 95% CI 0.390\u20131.43, p\u2009=\u20090.378).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec011\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>EPC patients were older and their tumours larger. There was no difference in Ki-67 index between EP and EPC groups. In the Cox multivariate analysis only age had a statistically significant effect on survival. According to our findings Ki-67 index might not be a decisive factor in the prognosis of EPC. Further studies to validate our current findings are warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0324975","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:43:35Z","timestamp":1748627015000},"page":"e0324975","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological comparison of eccrine poroma and porocarcinoma: Ki-67 index is not a decisive factor"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7192-8912","authenticated-orcid":true,"given":"Anna-Stiina","family":"Meril\u00e4inen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5265-5509","authenticated-orcid":true,"given":"Harri","family":"Sihto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorma","family":"Isola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virve","family":"Koljonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"12","key":"pone.0324975.ref001","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/j.1365-2133.1956.tb12776.x","article-title":"Hidroacanthoma simplex; an assessment of a selected group of intraepidermal basal cell epitheliomata and of their malignant homologues","volume":"68","author":"JG Coburn","year":"1956","journal-title":"Br J Dermatol"},{"key":"pone.0324975.ref002","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1001\/archderm.1963.01590230105015","article-title":"Epidermotropic eccrine carcinoma. A case combining features of eccrine poroma and Paget\u2019s dermatosis","volume":"88","author":"H Pinkus","year":"1963","journal-title":"Arch Dermatol"},{"issue":"4","key":"pone.0324975.ref003","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000253989","article-title":"Oncogenic differentiation of the intraepidermal eccrine sweat duct: eccrine poroma, poroepithelioma and porocarcinoma","volume":"138","author":"Y Mishima","year":"1969","journal-title":"Dermatologica"},{"issue":"2","key":"pone.0324975.ref004","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ad.2022.07.029","article-title":"Poroma: a retrospective series of 80 patients at a tertiary care Hospital","volume":"114","author":"C Moreno-V\u00edlchez","year":"2023","journal-title":"Actas Dermosifiliogr"},{"issue":"2","key":"pone.0324975.ref005","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/ced.12185","article-title":"Unusual sites for poromas are not very unusual: a survey of 101 cases","volume":"39","author":"R Betti","year":"2014","journal-title":"Clin Exp Dermatol"},{"issue":"4","key":"pone.0324975.ref006","doi-asserted-by":"crossref","first-page":"283","DOI":"10.5826\/dpc.0904a07","article-title":"Dermoscopic-histopathological correlation of eccrine poroma: an observational study","volume":"9","author":"MA Chessa","year":"2019","journal-title":"Dermatol Pract Concept"},{"issue":"5","key":"pone.0324975.ref007","doi-asserted-by":"crossref","first-page":"422","DOI":"10.5021\/ad.2020.32.5.422","article-title":"A Case of eccrine poromatosis in a patient with a history of chemotherapy due to stomach cancer","volume":"32","author":"IH Choi","year":"2020","journal-title":"Ann Dermatol"},{"issue":"5","key":"pone.0324975.ref008","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.abd.2021.10.006","article-title":"Pigmented eccrine poroma in an atypical location","volume":"97","author":"M Alfredo","year":"2022","journal-title":"An Bras Dermatol"},{"issue":"8","key":"pone.0324975.ref009","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1111\/jdv.14729","article-title":"Dermoscopy features and patterns of poromas: a multicentre observational case-control study conducted by the International Dermoscopy Society","volume":"32","author":"MA Marchetti","year":"2018","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"6","key":"pone.0324975.ref010","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/j.1365-2133.1982.tb00527.x","article-title":"Malignant eccrine poroma: a study of twenty-seven cases","volume":"107","author":"M Shaw","year":"1982","journal-title":"Br J Dermatol"},{"key":"pone.0324975.ref011","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ijscr.2016.10.051","article-title":"Porocarcinoma: A systematic review of literature with a single case report","volume":"30","author":"AM Salih","year":"2017","journal-title":"Int J Surg Case Rep"},{"issue":"8","key":"pone.0324975.ref012","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/j.1346-8138.2007.00324.x","article-title":"Eccrine porocarcinoma: clinical and pathological studies of 12 cases","volume":"34","author":"J Shiohara","year":"2007","journal-title":"J Dermatol"},{"issue":"9","key":"pone.0324975.ref013","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/ijd.12448","article-title":"Poroma: a review of eccrine, apocrine, and malignant forms","volume":"53","author":"JL Sawaya","year":"2014","journal-title":"Int J Dermatol"},{"issue":"5","key":"pone.0324975.ref014","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1111\/j.1365-2133.2011.10486.x","article-title":"Factors in the surgical management of primary eccrine porocarcinoma: prognostic histological factors can guide the surgical procedure","volume":"165","author":"E Belin","year":"2011","journal-title":"Br J Dermatol"},{"key":"pone.0324975.ref015","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.amsu.2017.06.027","article-title":"Porocarcinoma; presentation and management, a meta-analysis of 453 cases","volume":"20","author":"AM Salih","year":"2017","journal-title":"Ann Med Surg (Lond)"},{"issue":"5","key":"pone.0324975.ref016","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/ijd.12714","article-title":"Eccrine porocarcinoma: epidemiologic and histopathologic characteristics","volume":"54","author":"L Riera-Leal","year":"2015","journal-title":"Int J Dermatol"},{"issue":"17","key":"pone.0324975.ref017","article-title":"Polypoidal Manifestation of Multiple Poromas: Possible Drug Involvement","volume":"100","author":"Y Yoshida","year":"2020","journal-title":"Acta Derm Venereol"},{"issue":"2","key":"pone.0324975.ref018","doi-asserted-by":"crossref","first-page":"222","DOI":"10.5021\/ad.2018.30.2.222","article-title":"Eccrine Poroma with Rapid Growth during Pregnancy: A Case Report and Review of the Literature","volume":"30","author":"J Moon","year":"2018","journal-title":"Ann Dermatol"},{"issue":"8","key":"pone.0324975.ref019","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1002\/jso.23331","article-title":"Increasing incidence and survival of a rare skin cancer in the Netherlands. A population-based study of 2,220 cases of skin adnexal carcinoma","volume":"107","author":"H Stam","year":"2013","journal-title":"J Surg Oncol"},{"issue":"1","key":"pone.0324975.ref020","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/bjd.18874","article-title":"Demographics and outcomes of eccrine porocarcinoma: results from the National Cancer Database","volume":"183","author":"S Behbahani","year":"2020","journal-title":"Br J Dermatol"},{"issue":"6","key":"pone.0324975.ref021","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1097\/00000478-200106000-00002","article-title":"Eccrine porocarcinoma (malignant eccrine poroma): a clinicopathologic study of 69 cases","volume":"25","author":"A Robson","year":"2001","journal-title":"Am J Surg Pathol"},{"issue":"7","key":"pone.0324975.ref022","doi-asserted-by":"crossref","first-page":"691","DOI":"10.2340\/00015555-3173","article-title":"Evaluation of Sentinel Lymph Node Biopsy for Eccrine Porocarcinoma","volume":"99","author":"K Tsunoda","year":"2019","journal-title":"Acta Derm Venereol"},{"issue":"2","key":"pone.0324975.ref023","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/1203475420952432","article-title":"Characteristic Clinical and Dermoscopic Features of Nonvolar Poroma","volume":"25","author":"D-L Ha","year":"2021","journal-title":"J Cutan Med Surg"},{"issue":"10","key":"pone.0324975.ref024","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1097\/DSS.0000000000001566","article-title":"Eccrine porocarcinoma: new insights and a systematic review of the literature","volume":"44","author":"A Nazemi","year":"2018","journal-title":"Dermatol Surg"},{"issue":"8","key":"pone.0324975.ref025","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00403-020-02143-5","article-title":"Surgical management and lymph-node biopsy of rare malignant cutaneous adnexal carcinomas: a population-based analysis of 7591 patients","volume":"313","author":"A Goyal","year":"2021","journal-title":"Arch Dermatol Res"},{"issue":"3","key":"pone.0324975.ref026","doi-asserted-by":"crossref","first-page":"223","DOI":"10.5021\/ad.2020.32.3.223","article-title":"Eccrine Porocarcinoma: A Multicenter Retrospective Study with Review of the Literatures Reported in Korea","volume":"32","author":"HJ Kim","year":"2020","journal-title":"Ann Dermatol"},{"issue":"9","key":"pone.0324975.ref027","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1111\/ijd.16129","article-title":"Porocarcinoma: an epidemiological, clinical, and dermoscopic 20-year study","volume":"61","author":"V De Giorgi","year":"2022","journal-title":"Int J Dermatol"},{"issue":"2","key":"pone.0324975.ref028","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1093\/ced\/llac052","article-title":"Variation in management of porocarcinoma: a 10-year retrospective review of 75 cases across three UK tertiary centres","volume":"48","author":"RT Winn","year":"2023","journal-title":"Clin Exp Dermatol"},{"issue":"4","key":"pone.0324975.ref029","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.4049\/jimmunol.133.4.1710","article-title":"Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by the monoclonal antibody Ki-67","volume":"133","author":"J Gerdes","year":"1984","journal-title":"J Immunol"},{"issue":"2","key":"pone.0324975.ref030","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s10549-013-2560-8","article-title":"Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry","volume":"139","author":"EC Inwald","year":"2013","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"pone.0324975.ref031","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1346-8138.2003.tb00330.x","article-title":"Prognostic value of Ki-67, CD31 and epidermal growth factor receptor expression in basal cell carcinoma","volume":"30","author":"O Yerebakan","year":"2003","journal-title":"J Dermatol"},{"issue":"3","key":"pone.0324975.ref032","doi-asserted-by":"crossref","first-page":"517","DOI":"10.5114\/ada.2022.117598","article-title":"Role of Bcl-2, p53, and Ki-67 expression in basal cell carcinoma and their association with aggressive and non-aggressive histological phenotypes","volume":"39","author":"RG Mendez-Flores","year":"2022","journal-title":"Postepy Dermatol Alergol"},{"issue":"4","key":"pone.0324975.ref033","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s12022-020-09640-3","article-title":"Exploring the Prognostic Role of Ki67 Proliferative Index in Merkel Cell Carcinoma of the Skin: Clinico-Pathologic Analysis of 84 Cases and Review of the Literature","volume":"31","author":"S La Rosa","year":"2020","journal-title":"Endocr Pathol"},{"issue":"11","key":"pone.0324975.ref034","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1097\/DAD.0000000000002555","article-title":"Comparison of Melanocyte-Associated Immunohistochemical Markers in Acral Lentiginous Melanoma and Acral Benign Nevi","volume":"45","author":"JC Kim","year":"2023","journal-title":"Am J Dermatopathol"},{"issue":"6","key":"pone.0324975.ref035","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.pathol.2023.07.001","article-title":"Aberrant p16, p53 and Ki-67 immunohistochemistry staining patterns can distinguish solitary keratoacanthoma from cutaneous squamous cell carcinoma","volume":"55","author":"RA Carr","year":"2023","journal-title":"Pathology"},{"issue":"1","key":"pone.0324975.ref036","first-page":"33","article-title":"Results of Surgical Treatment of Patients with Malignant Eccrine Poroma","volume":"53","author":"SK Yazar","year":"2019","journal-title":"Sisli Etfal Hastan Tip Bul"},{"issue":"2","key":"pone.0324975.ref037","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1365-2133.1983.tb07084.x","article-title":"Hidroacanthoma simplex--a review of 15 cases","volume":"109","author":"H Rahbari","year":"1983","journal-title":"Br J Dermatol"},{"issue":"5","key":"pone.0324975.ref038","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/DAD.0b013e3181bc91ff","article-title":"From hidroacanthoma simplex to poroid hidradenoma: clinicopathologic and immunohistochemic study of poroid neoplasms and reappraisal of their histogenesis","volume":"32","author":"M Battistella","year":"2010","journal-title":"Am J Dermatopathol"},{"issue":"2","key":"pone.0324975.ref039","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1109\/TMI.2019.2933656","article-title":"Cytokeratin-Supervised Deep Learning for Automatic Recognition of Epithelial Cells in Breast Cancers Stained for ER, PR, and Ki-67","volume":"39","author":"M Valkonen","year":"2020","journal-title":"IEEE Trans Med Imaging"},{"issue":"4","key":"pone.0324975.ref040","doi-asserted-by":"crossref","DOI":"10.1186\/bcr2615","article-title":"ImmunoRatio: a publicly available web application for quantitative image analysis of estrogen receptor (ER), progesterone receptor (PR), and Ki-67","volume":"12","author":"VJ Tuominen","year":"2010","journal-title":"Breast Cancer Res"},{"issue":"4","key":"pone.0324975.ref041","first-page":"291","article-title":"Quantification of histochemical staining by color deconvolution","volume":"23","author":"AC Ruifrok","year":"2001","journal-title":"Anal Quant Cytol Histol"},{"issue":"1","key":"pone.0324975.ref042","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1365-2133.1986.tb06228.x","article-title":"Three cases of eccrine porocarcinoma","volume":"115","author":"L Puttick","year":"1986","journal-title":"Br J Dermatol"},{"issue":"16","key":"pone.0324975.ref043","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.3390\/diagnostics13162689","article-title":"Eccrine Poroma: Pathogenesis, New Diagnostic Tools and Association with Porocarcinoma-A Review","volume":"13","author":"E Kyrmanidou","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"pone.0324975.ref044","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.humpath.2015.12.015","article-title":"Porocarcinomas harbor recurrent HRAS-activating mutations and tumor suppressor inactivating mutations","volume":"51","author":"P Harms","year":"2016","journal-title":"Hum Pathol"},{"issue":"3","key":"pone.0324975.ref045","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.pathol.2017.10.011","article-title":"Targeted molecular profiling reveals genetic heterogeneity of poromas and porocarcinomas","volume":"50","author":"M Bosic","year":"2018","journal-title":"Pathology"},{"issue":"1","key":"pone.0324975.ref046","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s13023-025-03586-7","article-title":"Whole-exome sequencing identifies distinct genomic aberrations in eccrine porocarcinomas and poromas","volume":"20","author":"M Puttonen","year":"2025","journal-title":"Orphanet J Rare Dis"},{"issue":"1","key":"pone.0324975.ref047","article-title":"Malignant Eccrine Porocarcinoma in Finland During 2007 to 2017","volume":"101","author":"A-S Meril\u00e4inen","year":"2021","journal-title":"Acta Derm Venereol"},{"issue":"1","key":"pone.0324975.ref048","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1365-2230.1995.tb01278.x","article-title":"Assessment of cellular proliferation of eccrine acrospiromas and eccrine sweat gland carcinomas by AgNOR counting and immunohistochemical demonstration of proliferating cell nuclear antigen (PCNA) and Ki-67","volume":"20","author":"S Ansai","year":"1995","journal-title":"Clin Exp Dermatol"},{"issue":"6","key":"pone.0324975.ref049","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1034\/j.1600-0560.2000.027006292.x","article-title":"Cell proliferation in skin tumors with ductal differentiation: patterns and diagnostic applications","volume":"27","author":"L Pozo","year":"2000","journal-title":"J Cutan Pathol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324975","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:43:46Z","timestamp":1748627026000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324975"}},"subtitle":[],"editor":[{"given":"Habib","family":"Boukerche","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":49,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0324975","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}