Sonic hedgehog marķiera ekspresijas īpatnības dažādu tipu bazālo šūnu karcinomās (BCC)
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Bazālo šūnu karcinoma (BŠK) ir visbiežāk diagnosticētais ļaundabīgais ādas audzējs. Klīniski BŠK parasti izpaužas kā sarkani vai rozā, cieti ar velvētu malu ādas pacēlumi, kas pieskaroties bieži vien nav sāpīgas. Audzēja vidusdaļā bieži ir vērojama nekroze, bet apkārt redzams izteikts asinsvadu tīklojums. Biežākā lokalizācija ir sejas un žokļu rajonā, jo tiem ir vislielākā saskare ar saules stariem. BŠK metastāzes ir ļoti reta parādība, savukārt recidīvi ir sastopami līdz pat 40 % gadījumu. Salīdzinot ar primāriem audzējiem, kas aug ļoti lēni, recidīva gadījumā BŠK var palielināties izmēros ļoti īsā laikā.
Darba mērķis bija novērtēt stromālās un audzēja Shh ekspresijas īpatnības dažādos BŠK tipos, izmantojot imūnhistoķīmijas metodi.
Materiāls un metodes. Materiāls tika iegūts BŠK operāciju laikā. Audu gabaliņi tika fiksēti formalīnā un ielieti parafīnā. Imūnhistoķīmiskās reakcijas tika veiktas ar anti-Shh antivielu. Veicot izteiktības novērtējumu audzējā un stromā, tika izmantota puskvantitatīvā pieeja. Pavisam tika analizēti 70 preparāti. Katrā preparātā tika apskatīti 20 gan audzēja, gan stromālā komponenta redzeslauki. Ekspresija tika vērtēta pēc šādas skalas: 0 - nav ekspresijas, 1 - vāja, 2 - vidēja un 3 - izteikta ekspresija, un tā attiecīgi bija 0 - 0%,1 - 0-10%, 2- 10-75% un 3 -> 75 %. BŠK tipi tika iedalīti šādās grupās: nodulārs, mikronodulārs, infiltratīvs un superficiāls audzējs, un tie tika analizēti, izmantojot IBM SPSS Statistics programmu. Preparāti tika pētīti ar Leica mikroskopu 400 reižu lielā palielinājumā.
Rezultāti. Salīdzinot ekspresiju stromā, augstāki rezultāti bija vērojami trīs tipu audzējiem, proti, superficiālam, infiltratīvam un mikronodulāram - attiecīgi 72,7, 69,5 un 64,9%. Nodulārai BŠK Shh imūnpozitivitāte bija vērojama tikai 38,7% visu redzeslauku, mikronodulārai un superficiālai biežāk bija sastopama vāja ekspresija - 45,4 un 40,4%. Savukārt infiltratīvam audzējam biežāk bija sastopama izteikta ekspresija - 47,9% gadījumu. Superficiāla audzēja tips, salidzinot ar mikronodulāru, parādīja arī biežāku vidēju un izteiktu ekspresiju, attiecīgi - 23,2 un 15%; 9,1 un 4,5%.
Salidzinot izteiktību audzējā, augstāki rezultāti bija vērojami trīs BSK tipiem - superficiālam, infiltratīvam un mikronodulāram. Superficiālas BŠK gadījumā ekspresijas trūkums audzējā netika novērots vispār. Izteikta ekspresija visbiežāk bija sastopama superficiālas un infiltrativas BŠK gadijumā, attiecīgi - 63.7 un 42,9%. Vidēja ekspresija biežāk bija novērojama mikronodulāras BŠK gadījumā, tā bija 48,3%. Vismazākā ekspresijas pozitivitāte bija vērojama nodulāras BŠK gadījumā.
Secinājumi. Augstākā audzēja un stromalā Shh ekspresija bija vērojama superficiālas, infiltrativas un mikronodulāras BŠK gadījumā. Izteiktības palielināšanās audzējā varētu norādīt uz audzēja agresivitāti un invāzijas potenciālu, savukārt palielināta ekspresija audzēja stromā norāda uz izmainītu mikrovidi, kas varētu būt turpmāko recidīvu iemesls.
Introduction. Basal cell carcinoma (BCC) is the most commonly diagnosed malignancy of the skin. Clinically, BCC is usually manifested as red or pink, hard skin with arched edges, which are often not painful to the touch. Necrosis is often seen in the middle of the tumor, but there is a marked vascular network around it. The most common localization is in the face and jaw area, as it has the greatest exposure to sunlight. BCC metastases are very rare, and relapses occur in up to 40% of cases. Compared to primary tumors that grow very slowly, in the case of relapse, BCC can increase in size in a very short time. The aim of the study was to evaluate the peculiarities of stromal and tumor Shh expression in different types of BCC using the method of immunohistochemistry. Material and methods. The material was obtained during BCC operations. Tissue pieces were fixed in formalin and embedded in paraffin. Immunohistochemical reactions were performed with the anti-Shh antibody. A semi-quantitative approach was used to assess expression in tumor and stroma. A total of 70 preparations were analyzed. Each field of view of both tumor and stromal components was examined in each preparation. Expression was rated on the following scale: 0-no expression, 1-weak, 2-moderate, and 3-strong expression, and were 0-0%, 1-0-10%, 2-10-75%, and 3> 75%. BCC types were divided into the following groups: nodular, micronodular, infiltrative, and superficial tumor, and were analyzed using the IBM SPSS Statistic program. The formulations were examined with a Leica microscope at 400x magnification. Results. Comparing the expression in the stroma, higher results were observed for three types of tumors, namely superficial, infiltrative, and micronodular - 72.7, 69.5%, and 64.9%, respectively. Nodular BCC Shh immunopositivity was observed in only 38.7% of all visual fields, micronodular and superficial were more frequently weak expression - 45.4 and 40.4%. Infiltrative tumors, on the other hand, were more frequently expressed in 47.9% of cases. Superficial tumor type compared to micronodular also showed more frequent moderate and pronounced expression, -23.2 and 15%, respectively; 9.1 and 4.5% Comparing the severity in the tumor, higher results were observed for three types of BCC - superficial, infiltrative, and micronodular. In the case of superficial BCC, no expression in the tumor was observed at all. Expressed expression was most common in superficial and infiltrative BCC, 63.7% and 42.9%, respectively. Moderate expression was more common in micronodular BCC at 48.3%. The lowest expression of positivity was observed in the case of nodular BCC. Conclusions. Higher tumor and stromal SHH expression were observed in superficial, infiltrative, and micronodular BCC. Increased tumor expression could indicate tumor aggressiveness and invasive potential, while increased expression in the tumor stroma indicates altered microenvironment, which may be a reason for further relapses.
Introduction. Basal cell carcinoma (BCC) is the most commonly diagnosed malignancy of the skin. Clinically, BCC is usually manifested as red or pink, hard skin with arched edges, which are often not painful to the touch. Necrosis is often seen in the middle of the tumor, but there is a marked vascular network around it. The most common localization is in the face and jaw area, as it has the greatest exposure to sunlight. BCC metastases are very rare, and relapses occur in up to 40% of cases. Compared to primary tumors that grow very slowly, in the case of relapse, BCC can increase in size in a very short time. The aim of the study was to evaluate the peculiarities of stromal and tumor Shh expression in different types of BCC using the method of immunohistochemistry. Material and methods. The material was obtained during BCC operations. Tissue pieces were fixed in formalin and embedded in paraffin. Immunohistochemical reactions were performed with the anti-Shh antibody. A semi-quantitative approach was used to assess expression in tumor and stroma. A total of 70 preparations were analyzed. Each field of view of both tumor and stromal components was examined in each preparation. Expression was rated on the following scale: 0-no expression, 1-weak, 2-moderate, and 3-strong expression, and were 0-0%, 1-0-10%, 2-10-75%, and 3> 75%. BCC types were divided into the following groups: nodular, micronodular, infiltrative, and superficial tumor, and were analyzed using the IBM SPSS Statistic program. The formulations were examined with a Leica microscope at 400x magnification. Results. Comparing the expression in the stroma, higher results were observed for three types of tumors, namely superficial, infiltrative, and micronodular - 72.7, 69.5%, and 64.9%, respectively. Nodular BCC Shh immunopositivity was observed in only 38.7% of all visual fields, micronodular and superficial were more frequently weak expression - 45.4 and 40.4%. Infiltrative tumors, on the other hand, were more frequently expressed in 47.9% of cases. Superficial tumor type compared to micronodular also showed more frequent moderate and pronounced expression, -23.2 and 15%, respectively; 9.1 and 4.5% Comparing the severity in the tumor, higher results were observed for three types of BCC - superficial, infiltrative, and micronodular. In the case of superficial BCC, no expression in the tumor was observed at all. Expressed expression was most common in superficial and infiltrative BCC, 63.7% and 42.9%, respectively. Moderate expression was more common in micronodular BCC at 48.3%. The lowest expression of positivity was observed in the case of nodular BCC. Conclusions. Higher tumor and stromal SHH expression were observed in superficial, infiltrative, and micronodular BCC. Increased tumor expression could indicate tumor aggressiveness and invasive potential, while increased expression in the tumor stroma indicates altered microenvironment, which may be a reason for further relapses.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
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Health Care
Keywords
Bazālā šūnu karcinoma, Sonic hedgehog, Basal cell carcinoma, Sonic hedgehog