Lupu Mihai, Caruntu Constantin, Popa Maria Iris, Voiculescu Vlad Mihai, Zurac Sabina, Boda Daniel
Department of Dermatology, MEDAS Medical Center, 030442 Bucharest, Romania.
Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Oncol Lett. 2019 May;17(5):4112-4125. doi: 10.3892/ol.2019.10070. Epub 2019 Feb 25.
Basal cell carcinoma (BCC) is the most prevalent skin cancer in the Caucasian population. A variety of different phenotypic presentations of BCC are possible. Although BCCs rarely metastasize, these tumors commonly destroy underlying tissues and should therefore be treated promptly. As vascular formation and angiogenesis are indicators of tumor development and progression, the presence of blood vessels, their morphology and architecture are important markers in skin lesions, providing critical information towards pathogenesis and diagnosis. BCC commonly lacks pigmentation, therefore it is important to emphasize the usefulness of vascular feature detection, recognition, quantification and interpretation. To answer the question of whether vascular patterns observed on dermoscopy, reflectance confocal microscopy (RCM) and histopathology might reflect the biologic behavior of BCCs, we undertook this review article. Several studies have sought, by various means, to identify vascular features associated with the more aggressive BCC phenotypes. Dermoscopic vascular pattern assessment can facilitate diagnostic discrimination between BCC subtypes, more aggressive BCCs displaying less or no pink coloration and a relative absence of central tumor vessels. RCM, a novel, non-invasive imaging technique, allows for the quantification of blood vessel size, density, and flow intensity in BCCs. BCCs are distinguished on RCM chiefly by vessels that branch and intertwine between neoplastic aggregates, a pattern strongly reflecting tumor neo-angiogenesis. The analysis of these vascular morphological and distribution patterns can provide further support in the diagnosis, assessment, or monitoring of BCCs. Histopathology shows significantly higher microvessel densities in the peritumoral stroma of BCCs, when compared to normal skin or benign tumors. This angiogenic response in the stroma is associated with local aggressiveness, therefore the quantification of peritumoralmicrovessels may further assist with tumor evaluation. How dermoscopy and RCM vascular patterns in BCC correlate with histopathological subtype and thus help in discriminating aggressive subtypes definitely deserves further investigation.
基底细胞癌（BCC）是白种人最常见的皮肤癌。BCC有多种不同的表型表现。虽然BCC很少发生转移，但这些肿瘤通常会破坏深层组织，因此应及时治疗。由于血管形成和血管生成是肿瘤发生发展的指标，血管的存在、形态和结构是皮肤病变的重要标志物，可为发病机制和诊断提供关键信息。BCC通常缺乏色素沉着，因此强调血管特征检测、识别、量化和解释的有用性很重要。为了回答在皮肤镜检查、反射式共聚焦显微镜（RCM）和组织病理学上观察到的血管模式是否可能反映BCC的生物学行为这一问题，我们撰写了这篇综述文章。几项研究通过各种方法试图确定与侵袭性更强的BCC表型相关的血管特征。皮肤镜血管模式评估有助于鉴别BCC亚型，侵袭性更强的BCC表现为粉色较少或无粉色，且相对缺乏中央肿瘤血管。RCM是一种新型的非侵入性成像技术，可对BCC中的血管大小、密度和血流强度进行量化。BCC在RCM上的主要特征是肿瘤细胞团之间分支并相互交织的血管，这种模式强烈反映肿瘤新生血管形成。对这些血管形态和分布模式的分析可为BCC的诊断、评估或监测提供进一步支持。与正常皮肤或良性肿瘤相比，组织病理学显示BCC肿瘤周围基质中的微血管密度明显更高。基质中的这种血管生成反应与局部侵袭性有关，因此肿瘤周围微血管的量化可能有助于进一步评估肿瘤。BCC的皮肤镜和RCM血管模式如何与组织病理学亚型相关联，从而有助于鉴别侵袭性亚型，这肯定值得进一步研究。
