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https://doi.org/10.4081/dr.2026.10904

Serum periostin levels in mycosis fungoides: associations with clinical subtype and disease stage

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Published: 31 July 2026
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Cutaneous T-cell lymphoma, case-control study, diagnostic accuracy, tumor microenvironment, TNMB classification

Authors

Ramazan Çetin
mdramazancetin95@gmail.com
https://orcid.org/0000-0001-9200-222X
Department of Dermatology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye.
Müge Güler Özden
Department of Dermatology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye.

Serum biomarkers with diagnostic and staging relevance in mycosis fungoides (MF) remain limited. In this prospective case-control study, we evaluated serum periostin levels in 40 patients with MF and 40 matched healthy controls, and assessed their associations with clinical subtype and disease stage. Serum periostin was measured by enzyme-linked immunosorbent assay (ELISA), and comparisons were performed using non-parametric tests. Serum periostin levels were significantly higher in patients with MF than in controls (p<0.0001). Receiver operating characteristic (ROC) analysis demonstrated moderate discrimination for MF, with an area under the curve (AUC) of 0.77 (95% confidence interval [CI], 0.67-0.88); the optimal cut-off was 7.50 ng/mL, yielding 74.36% sensitivity and 70.00% specificity. Periostin levels also differed significantly across clinical subtypes (Kruskal-Wallis, p<0.0001), with higher levels in patch and plaque disease than in tumor-stage disease. In addition, serum periostin was significantly higher in early-stage MF (IA-IIA) than in advanced-stage disease (IIB and above) (p=0.035). These findings support serum periostin as a supportive biomarker reflecting clinical subtype and stage in MF, warranting further validation.

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Scopus
Google Scholar
Europe PMC
1. Zinzani PL, Ferreri AJ, Cerroni L. Mycosis fungoides. Crit Rev Oncol Hematol 2008;65:172-82.
2. Larocca C, Kupper T. Mycosis fungoides and Sézary syndrome: an update. Hematol Oncol Clin North Am 2019;33:103-20.
3. Alberti-Violetti S, Talpur R, Schlichte M, et al. Advanced-stage mycosis fungoides and Sézary syndrome: survival and response to treatment. Clin Lymphoma Myeloma Leuk 2015;15:e105-12.
4. Johnson VE, Vonderheid EC, Hess AD, et al. Genetic markers associated with progression in early mycosis fungoides. J Eur Acad Dermatol Venereol 2014;28:1431-5.
5. Jawed SI, Myskowski PL, Horwitz S, et al. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part I. Diagnosis: clinical and histopathologic features and new molecular and biologic markers. J Am Acad Dermatol 2014;70:205.e1-16.
6. Rubio Gonzalez B, Zain J, Rosen ST, et al. Tumor microenvironment in mycosis fungoides and Sézary syndrome. Curr Opin Oncol 2016;28:88-96.
7. Izuhara K, Nunomura S, Nanri Y, et al. Periostin: an emerging biomarker for allergic diseases. Allergy 2019;74:2116-28.
8. Kudo Y, Siriwardena BS, Hatano H, et al. Periostin: novel diagnostic and therapeutic target for cancer. Histol Histopathol 2007;22:1167-74.
9. Ruan K, Bao S, Ouyang G. The multifaceted role of periostin in tumorigenesis. Cell Mol Life Sci 2009;66:2219-30.
10. Furudate S, Fujimura T, Kakizaki A, et al. The possible interaction between periostin expressed by cancer stroma and tumor-associated macrophages in developing mycosis fungoides. Exp Dermatol 2016;25:107-12.
11. Takahashi N, Sugaya M, Suga H, et al. Thymic stromal lymphopoietin acts through Th2 cytokine production to induce cutaneous T-cell lymphoma. Cancer Res 2016;76:6241-52.
12. Olsen E, Vonderheid E, Pimpinelli N, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC). Blood 2007;110:1713-22.
13. Panos GD, Boeckler FM. Statistical analysis in clinical and experimental medical research: simplified guidance for authors and reviewers. Drug Des Devel Ther 2023;17:1959-61.
14. Ion A, Popa IM, Papagheorghe LM, et al. Proteomic approaches to biomarker discovery in cutaneous T-cell lymphoma. Dis Markers 2016;2016:9602472.
15. González-González L, Alonso J. Periostin: a matricellular protein with multiple functions in cancer development and progression. Front Oncol 2018;8:225.
16. Sahai E, Astsaturov I, Cukierman E, et al. A framework for advancing our understanding of cancer-associated fibroblasts. Nat Rev Cancer 2020;20:174-86.
17. Zhu M, Fejzo MS, Anderson L, et al. Periostin promotes ovarian cancer angiogenesis and metastasis. Gynecol Oncol 2010;119:337-44.
18. Kotobuki Y, Yang L, Serada S, et al. Periostin accelerates human malignant melanoma progression by modifying the melanoma microenvironment. Pigment Cell Melanoma Res 2014;27:630-9.
19. Gordon ED, Sidhu SS, Wang ZE, et al. A protective role for periostin and TGF-beta in IgE-mediated allergy and airway hyperresponsiveness. Clin Exp Allergy 2012;42:144-55.
20. Gjerdrum LM, Woetmann A, Odum N, et al. FOXP3+ regulatory T cells in cutaneous T-cell lymphomas: association with disease stage and survival. Leukemia 2007;21:2512-8.
21. Beyer M, Schultze JL. Regulatory T cells in cancer. Blood 2006;108:804-11.
22. Woo EY, Yeh H, Chu CS, et al. Cutting edge: regulatory T cells from lung cancer patients directly inhibit autologous T-cell proliferation. J Immunol 2002;168:4272-6.
23. Gaydosik AM, Stonesifer CJ, Tabib T, et al. The mycosis fungoides cutaneous microenvironment shapes dysfunctional cell trafficking, antitumor immunity, matrix interactions, and angiogenesis. JCI Insight 2023;8:e170682.

Supporting Agencies

This study was financially supported by the Scientific Research Projects Coordination Unit of Ondokuz Mayıs University (Project No.: PYO.TIP.1904.23.001). The funder had no role in the study design, data collection, data analysis, interpretation of the data, manuscript preparation, or the decision to submit the manuscript for publication.

How to Cite



1.
Çetin R, Güler Özden M. Serum periostin levels in mycosis fungoides: associations with clinical subtype and disease stage. Dermatol Reports [Internet]. 2026 Jul. 31 [cited 2026 Sep. 3];. Available from: https://journals.pagepress.net/dr/article/view/10904
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