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M. E. Orellana, G. A. Novais, D. M. Abdulmannan, S. C. Maloney, S. Di Cesare, M. N. Burnier, Jr.; Immunohistochemical Profile Comparing Nodular and Morphea Type Basal Cell Carcinomas and Papillomas of the Eyelid. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3517.
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Basal cell carcinoma (BCC) is the most common skin and periocular malignancy. Of all skin BCC, 86% involves the head; 14% to 16.6% is located in the periocular area. BCC can be divided into different subtypes, of which nodular type is the most common with a relatively good prognosis. On the other hand, morphea type places patients at high risk for more aggressive disease. The aim of this study was to determine immunohistochemical differences between BCC and non-invading lesions such as squamous cell papillomas (SCP); and also to compare the immunohistochemical behavior of two different subtypes of BCC (nodular and morphea).
Twenty eight BCC (17 nodular, and 11 morphea), and ten SCP cases were histopathologically diagnosed and further analyzed by immunohistochemistry using the following antibodies: Epithelial Cell Adhesion Molecule (EpCAM), cytokeratin 8 (CAM 5.2), lysyl oxidase-like 2 (LOXL2), and Collagen IV. Epithelial and stromal (dermal) immunostaining were assessed in terms of intensity and extent for each marker.
Cytoplasmic expression of EpCAM and CAM 5.2 was strong in 24 of 28 (86%) and 27 of 28 (96%) BCC cases, respectively. Both markers were negative in all SCP cases (Fisher Exact Test, p < 0.0001). Peritumoral stromal tissue was positive for Collagen IV in 13 of 28 BCC cases, while was negative in all SCP cases (Fisher Exact Test, p < 0.0001). Immunostaining for LOXL2 was similar in both groups (60.71% BCC and 60% SCP). The comparison between solid and morphea BCC type showed no statistically significant differences for any of these markers.
These results suggest that the cells forming BCC lesions are different clones from the squamous cell papilloma cells, and those cells produce focal collagen changes due to their invasiveness. The differences between the behavior of nodular and morphea BCC types in our study was not related to promoting epithelial-mesenchymal transition, tested with LOXL2.
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