Bazal Hücreli Karsinomun Farklı Histolojik Alt Tiplerinde Androjen Reseptörü Ekspresyonunun Değerlendirilmesi

Öz

En sık görülen deri kanseri olan Bazal Hücreli Karsinom (BHK)’un sık rastlanan alt tipleri adenoid, nodüler ve yüzeyel tipleridir. Potansiyel bir onkogen rolü olduğu düşünülen Androjen reseptör (AR) geni, steroid hormon reseptör ailesinin bir üyesidir ve X kromozomunda lokalizedir. Çalışmamızda, androjen ekspresyonunun nodüler, yüzeyel ve adenoid BHK alt tiplerinde değerlendirilmesi amaçlanmıştır. Bu çalışmaya Balıkesir Üniversitesi Patoloji Bölümünde, BHK’un; adenoid, nodüler ve süperfisyal alt tip tanısı alan 60 olgu dahil edildi. Androjen’in immunohistokimyasal ekspresyonu, ışık mikroskobunda boyanma oranı açısından değerlendirildi. Pozitif boyanan hücrelerin boyanma oranı semikantitatif olarak derecelendirilerek aşağıdaki kategorilerden birine dahil edildi; Grup 1: (0-4%), Grup 2:(5-29 %), Grup 3: (30-59 %), Grup 4: (60-100 %). Androjen yüzdesinin dağılımı açısından BHK alt tipleri arasında anlamlı fark bulundu ve bu fark istatistiksel olarak ileri düzeyde anlamlıydı (p<0,001). Sonuç olarak, literatürdeki bulgular ile çalışmamızın verileri birlikte değerlendirildiğinde, androjen ekspresyonunun BHK alt tiplerinin ayrımında anlamlı bir belirleyici olabileceği görülmüştür. Özellikle yüzeyel tip BHK’da androjen ekspresyonunun belirgin düzeyde yüksek olması, alt tip sınıflandırmasına katkı sağlayabileceğini düşündürmektedir.

Anahtar Kelimeler

• Bazal Hücreli Karsinom
• Alt tip
• Androjen

Evaluation of Androgen Receptor Expression in Different Histological Subtypes of Basal Cell Carcinoma

Öz

The most common skin cancer, basal cell carcinoma (BCC), has the most common subtypes: adenoid, nodular, and superficial. The androgen receptor (AR) gene, thought to have a potential oncogenic role, is a member of the steroid hormone receptor family and is localized on the X chromosome. Our study aimed to evaluate androgen expression in nodular, superficial, and adenoid BCC subtypes. This study included 60 cases diagnosed with adenoid, nodular, and superficial BCC subtypes at the Department of Pathology at Balıkesir University. AR immunohistochemical expression was evaluated by light microscopy using staining ratios. Positive cells were assigned to one of four groups based on their staining ratios: Group 1: (0-4%), Group 2: (5-29%), Group 3: (30-59%), and Group 4: (60-100%). A significant difference was found between the BCC subtypes in terms of AR expression (%) distribution, and this difference was highly statistically significant (p<0.001). In conclusion, when the findings in the literature and our study are evaluated together, these findings suggest that androgen expression may be a significant determinant in distinguishing BCC subtypes. The significantly higher androgen expression, particularly in superficial BCC, suggests that it may contribute to subtype classification.

Anahtar Kelimeler

• Basal Cell Carcinoma
• Subtype
• Androgene

Kaynakça

1. 1. Goto M, Kai Y, Arakawa S, Oishi M, Ishikawa K, Anzai S, et al. Analysis of 256 cases of basal cell carcinoma after either one-step or two-step surgery in a Japanese institution. J Dermatol. 2012;39:68–71.
2. 2. Patterson JW. Tumors of the epidermis. In: Patterson JW, ed. Weedon’s Skin Pathology. 5th ed. Elsevier; 2021:848858.
3. 3. Hauschild AH, Breuninger H, Kaufmann R, et al. S2k guidelines—Basal cell carcinoma of the skin. J Dtsch Dermatol Ges. 2013;3:1015.
4. 4. Rubin AI, Chen EH, Ratner D. Basal-cell carcinoma. N Engl J Med. 2005;353(21):22622269.
5. 5. Messina J, Epstein EJ, Kossard S, et al. Basal cell carcinoma. In: Elder DE, Massi D, Scolyer RA, Willemze R, eds. WHO Classification of Skin Tumors. 4th ed. Lyon: IARC; 2018:2634.
6. 6. Tambe SA, Ghate SS, Jerajani HR. Adenoid type of basal cell carcinoma: Rare histopathological variant at an unusual location. Indian J Dermatol. 2013;58:159.
7. 7. Kim SH, Ko WT, Suh MK, Lee JI. A case of axillary adenoid basal cell carcinoma. Ann Dermatol. 2008;20:2225.
8. 8. Koplin L, Zarem HA. Recurrent basal cell carcinoma: A review concerning the incidence, behavior, and management of recurrent basal cell carcinoma, with emphasis on the incompletely excised lesion. Plast Reconstr Surg. 1980;65(5):656–664.

9. 9. Aristomenis A, Van Marion AM, Lohman BG, et al. Differentiation between basal cell carcinoma and trichoepithelioma by immunohistochemical staining of the androgen receptor: An overview. Eur J Dermatol. 2011;21(6):870873.
10. 10. Lamont KR, Tindall DJ. Alternative activation pathways for the androgen receptor in prostate cancer. Endocr Relat Cancer. 2011;18:R183R196.
11. 11. Liao DJ, Dickson RB. Roles of androgens in the development, growth, and carcinogenesis of the mammary gland. J Steroid Biochem Mol Biol. 2002;80(2):175189.
12. 12. Nadeen AM, Raja H, Mohammad AS, et al. Trichoblastoma mimicking basal cell carcinoma and approach to its treatment: A case report. Int J Surg Case Rep. 2021;86:106318.
13. 13. Telfer NR, Colver GB, Morton CA. Guidelines for the management of basal cell carcinoma. Br J Dermatol. 2008;159:3548.
14. 14. Kanitakis J, Bourchany D, Claudy A. Expression of CD10 antigen (neutral endopeptidase) by mesenchymal tumors of the skin. Anticancer Res. 2000;20:35393544.
15. 15. Evangelista MT, North JP. Comparative analysis of cytokeratin 15, TDAG51, cytokeratin 20 and androgen receptor in sclerosing adnexal neoplasms and basal cell carcinoma variants. J Cutan Pathol. 2015;42:824831.
16. 16. Astarcı HM, Gürbüz GA, Şengül D, et al. Significance of androgen receptor and CD10 expression in cutaneous basal cell carcinoma and trichoepithelioma. Oncol Lett. 2015;10(6):3466–3470. doi:10.3892/ol.2015.3743.
17. 17. Lee YF, Chang YT, Liu HN. Differentiating basal cell carcinoma from trichoepithelioma by using androgen receptor expression. Dermatologica Sinica. 2009;27(3):154–160. doi:10.1016/S1027-8117(09)70037-3.
18. 18. Arits AH, Van Marion AM, Lohman BG, et al. Differentiation between basal cell carcinoma and trichoepithelioma by immunohistochemical staining of the androgen receptor: An overview. Eur J Dermatol. 2011;21(6):870–873. doi:10.1684/ejd.2011.1506.