Study of Basal Cell Carcinoma Over a Five year period with Histomorphological Factors that Influences its Prognosis including Recurrence

Preethi Mary Eapen, (2020) Study of Basal Cell Carcinoma Over a Five year period with Histomorphological Factors that Influences its Prognosis including Recurrence. Masters thesis, Christian Medical College, Vellore.

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Abstract

INTRODUCTION: Basal cell carcinoma(BCC) is the most common skin cancer worldwide. Basal cell carcinoma accounts for 75% of cases of all non-melanoma skin cancer worldwide. The incidence of BCC in the European population was 98.6 per 100,000 people per year Comparatively the incidence is reduced in Asians and Africans due to increase in melanin pigment in the skin. Many risk factors have been postulated in basal cell carcinoma like increased exposure to sunlight, immunodeficiency, exposure to arsenic, lighter skin, scars, etc. Pathogenesis of basal cell carcinoma is said to be due to UV rays which induce production of pyrimidine dimers and loss of heterozygosity of both tumor-suppressive genes-P53 and PTCH, resulting in BCC. The mutations in the p53 tumor suppressor gene prevent apoptosis of UV-damaged cells. The tumor-suppressor gene P53 and melanocortin-1 receptor gene are also important for the development of the neoplastic process. OBJECTIVES: To identify the predisposing factors and histomorphological parameters that influence the recurrence in basal cell carcinoma and the incidence of p53 positivity in the same over a 5yr period. METHODS: A total of 168 patients with BCC over a 5year period from January 2013 to December 2017 were included in this study. Detailed history like age, gender, duration of symptoms, genetic disorders, previous treatment and recurrence were collected. The histomorphological features like depth of invasion, ulceration, inflammation, perineural or lymphovascular invasion were observed. P53 immunohistochemistry was done for 107 cases and its relevance to the type and recurrence of basal cell carcinoma were identified. Based on the clinical and histopathological findings, the results were computed and analyzed using SPSS 16.0 software using Chi-square and Fisher exact test. RESULTS: BCC was detected between 40 to70 years with no gender bias. The commonest site involved was the H area of face. Solar elastosis, actinic keratosis, Bowens were seen associated with BCC. Nodular and pigmented subtypes were the commonest. Recurrence was associated with PNI, depth of invasion, tumor infiltrating lymphocytes and margin of clearance. 80.3% of BCCs were positive for p53. CONCLUSION: The best predictor of recurrence was the stratification into high risk and low risk. PNI was significantly associated with recurrence (p value < 0.05). Low p53 score was observed with aggressive variants.

Item Type: Thesis (Masters)
Additional Information: 201713356
Uncontrolled Keywords: Basal cell carcinoma (BCC), Recurrence, p53, Perineural inflammation (PNI).
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 18:10
Last Modified: 29 Jan 2021 18:10
URI: http://repository-tnmgrmu.ac.in/id/eprint/13434

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