L Schmitz1, T Gambichler1, C Kost1, G Gupta2,3, M Stücker1, E Stockfleth1, T Dirschka4,5. 1. Department of Dermatology, Venereology and Allergology, Ruhr-University, Gudrunstraße 56, D-44791, Bochum, Germany. 2. Department of Dermatology, University Hospital Monklands, Lanarkshire, U.K. 3. School of Medicine, University of Glasgow, Glasgow, U.K. 4. CentroDerm Clinic, Heinz-Fangman-Straße 57, Wuppertal, Germany. 5. Faculty of Health, University Witten-Herdecke, Alfred-Herrhausen-Straße 50, Witten, Germany.
Abstract
BACKGROUND: In addition to the extent of atypical keratinocytes throughout the epidermis, actinic keratoses (AKs) are histologically characterized by downward-directed basal-layer expansion. It is not known whether this growth pattern correlates with the risk of developing invasive squamous cell carcinoma (iSCC). OBJECTIVES: To characterize the prevalence of downward-directed basal-layer expansion of AKs adjacent to iSCC. METHODS: The epidermis overlying and adjacent to iSCCs was assessed histologically. We determined the histological grade (AK I-III), basal growth pattern (PRO I-III) and accompanying parameters such as adnexal involvement. RESULTS: Among 307 lesions, 52·4% of AKs were histologically classified as AK grade I, 38·1% as AK II and 6·8% as AK III (χ2 -test, P < 0·001). Only 2·6% of adjacent epidermal samples did not show any atypical keratinocytes. The epidermis adjacent to iSCCs was classified as having a PRO I basal growth pattern in 25·7%, PRO II in 31·9% and PROIII in 39·4% of cases. Only 2·9% of AKs showed no basal growth (χ2 -test, P < 0·001). In total 118 AKs (48·8%) showed extension into adnexal structures. These AKs were graded as PRO I in 18·6% of cases, PRO II in 30·5% and PRO III in 50·8%. The epidermis above iSCCs could be assessed only for upwards-directed growth and showed no significant differences in the three AK grades (P = 0·42). CONCLUSIONS: Basal proliferative AKs, as well as atypical keratinocytes restricted to the lower third of the epidermis, are most commonly seen adjacent to iSCC, with less evidence for full-thickness epidermal dysplasia. Our study supports the important role of dysplastic keratinocytes in the epidermal basal layer and their potential association with iSCC.
BACKGROUND: In addition to the extent of atypical keratinocytes throughout the epidermis, actinic keratoses (AKs) are histologically characterized by downward-directed basal-layer expansion. It is not known whether this growth pattern correlates with the risk of developing invasive squamous cell carcinoma (iSCC). OBJECTIVES: To characterize the prevalence of downward-directed basal-layer expansion of AKs adjacent to iSCC. METHODS: The epidermis overlying and adjacent to iSCCs was assessed histologically. We determined the histological grade (AK I-III), basal growth pattern (PRO I-III) and accompanying parameters such as adnexal involvement. RESULTS: Among 307 lesions, 52·4% of AKs were histologically classified as AK grade I, 38·1% as AK II and 6·8% as AK III (χ2 -test, P < 0·001). Only 2·6% of adjacent epidermal samples did not show any atypical keratinocytes. The epidermis adjacent to iSCCs was classified as having a PRO I basal growth pattern in 25·7%, PRO II in 31·9% and PROIII in 39·4% of cases. Only 2·9% of AKs showed no basal growth (χ2 -test, P < 0·001). In total 118 AKs (48·8%) showed extension into adnexal structures. These AKs were graded as PRO I in 18·6% of cases, PRO II in 30·5% and PRO III in 50·8%. The epidermis above iSCCs could be assessed only for upwards-directed growth and showed no significant differences in the three AK grades (P = 0·42). CONCLUSIONS: Basal proliferative AKs, as well as atypical keratinocytes restricted to the lower third of the epidermis, are most commonly seen adjacent to iSCC, with less evidence for full-thickness epidermal dysplasia. Our study supports the important role of dysplastic keratinocytes in the epidermal basal layer and their potential association with iSCC.
Authors: Clara Curiel-Lewandrowski; Caitlyn N Myrdal; Kathylynn Saboda; Chengcheng Hu; Edith Arzberger; Giovanni Pellacani; Franz Josef Legat; Martina Ulrich; Petra Hochfellner; Margaret C Oliviero; Paola Pasquali; Melissa Gill; Rainer Hofmann-Wellenhof Journal: Cancers (Basel) Date: 2021-10-31 Impact factor: 6.575
Authors: Elena Campione; Monia Di Prete; Cosimo Di Raimondo; Gaetana Costanza; Vincenzo Palumbo; Virginia Garofalo; Sara Mazzilli; Chiara Franceschini; Emi Dika; Luca Bianchi; Augusto Orlandi Journal: Int J Mol Sci Date: 2022-09-26 Impact factor: 6.208
Authors: Ignazio Stanganelli; Francesco Spagnolo; Giuseppe Argenziano; Paolo A Ascierto; Franco Bassetto; Paolo Bossi; Vittorio Donato; Daniela Massi; Cesare Massone; Roberto Patuzzo; Giovanni Pellacani; Pietro Quaglino; Paola Queirolo; Iris Zalaudek; Giuseppe Palmieri Journal: Cancers (Basel) Date: 2022-01-13 Impact factor: 6.639