El Hanbuli Hala M, Abou Sari Mostafa A, Dawoud Noha M
Pathology Department, Faculty of Medicine, Fayoum University, Al Fayoum.
Dermatology, Andrology and STDs Department, Faculty of Medicine, Menoufia University, Shebine Elkom, Egypt.
Appl Immunohistochem Mol Morphol. 2023 Apr 1;31(4):245-254. doi: 10.1097/PAI.0000000000001107. Epub 2023 Feb 28.
Xeroderma pigmentosa (XP) is a rare genetic disorder that is characterized by defective DNA repair after ultraviolet induced damage with a great tendency for recurrent cutaneous malignancies including basal cell carcinoma (BCC). BCC is frequently linked to impaired local immune response with a major role played by Langerhans cells (LCs). The current study aims at investigating LCs in BCC specimens of XP and non-XP patients, in a trial to study its possible impact on tumor recurrence. It included 48 retrospective cases of primary facial BCC (18 for XP patients and 30 for non-XP controls). Each group was subdivided, based on the 5 years follow-up data, into recurrent and non-recurrent BCC groups. LCs were assessed immunohistochemically using the sensitive marker; CD1a. Results showed significantly reduced LCs count (intratumoral, peritumoral, and in perilesional epidermis) in XP patients compared with non-XP controls ( P ˂0.001 for all). Intratumoral ( P =0.008), peritumoral ( P =0.005), and perilesional epidermal ( P =0.02) LCs mean values were significantly lower in recurrent versus non-recurrent BCC specimens. Also, within each group (XP and controls), LCs were of significantly lower means in recurrent versus non-recurrent cases ( P ≤0.001 for all). Regarding recurrent BCC cases, peritumoral LCs showed a significant positive correlation with 1ry BCC duration ( P =0.05). Also, intratumoral and peritumoral LCs correlated positively with BCC relapse interval ( P =0.04 for both). Among non-XP controls, periocular tumors had the least LCs count (22.00±3.56), whereas tumors located in the rest of the face had the greatest count (29.00±0.00) ( P =0.02). Sensitivity and specificity of LCs to predict BCC recurrence in XP patients reached 100% in intartumoral area and perilesional epidermis when cutoff points were less than 9.5 and 20.5, respectively. In conclusion; reduced LC count in primary BCC specimens of XP patients and also in normal subjects could help to predict its recurrence. Thus, it might be identified as a risk factor for relapse to apply new strict therapeutic and preventive measures. This presents new avenue for the immunosurveillance against skin cancer relapse. However, being the first study to investigate that link in XP patients recommends further research to confirm.
着色性干皮病（XP）是一种罕见的遗传性疾病，其特征是紫外线诱导损伤后DNA修复缺陷，极易发生复发性皮肤恶性肿瘤，包括基底细胞癌（BCC）。BCC常与局部免疫反应受损有关，朗格汉斯细胞（LCs）起主要作用。本研究旨在调查XP患者和非XP患者BCC标本中的LCs，以研究其对肿瘤复发的可能影响。该研究纳入了48例原发性面部BCC的回顾性病例（18例为XP患者，30例为非XP对照）。根据5年随访数据，每组又分为复发性和非复发性BCC组。使用敏感标志物CD1a通过免疫组织化学方法评估LCs。结果显示，与非XP对照相比，XP患者的LCs计数（肿瘤内、肿瘤周围和病变周围表皮）显著降低（所有P值均<0.001）。复发性BCC标本的肿瘤内（P =0.008）、肿瘤周围（P =0.005）和病变周围表皮（P =0.02）LCs平均值显著低于非复发性标本。此外，在每组（XP组和对照组）中，复发性病例的LCs平均值显著低于非复发性病例（所有P值均≤0.001）。对于复发性BCC病例，肿瘤周围LCs与原发性BCC病程呈显著正相关（P =0.05）。此外，肿瘤内和肿瘤周围LCs与BCC复发间隔呈正相关（两者P值均为0.04）。在非XP对照组中，眼周肿瘤的LCs计数最少（22.00±3.56），而面部其他部位的肿瘤计数最多（29.00±0.00）（P =0.02）。当肿瘤内区域和病变周围表皮的截断点分别小于9.5和20.5时，LCs预测XP患者BCC复发的敏感性和特异性分别达到100%。总之，XP患者原发性BCC标本以及正常受试者中LCs计数减少有助于预测其复发。因此，它可能被确定为复发的危险因素，以便采取新的严格治疗和预防措施。这为皮肤癌复发的免疫监视提供了新途径。然而，作为第一项研究XP患者中该关联的研究，建议进一步研究以证实。
