Apoptotic markers in photoinduced cutaneous carcinoma

Cutaneous carcinomas are malignant lesions, which most commonly occur on photo-aggressed site. The purpose of our study was to evaluate the immunohistochemical expression of three apoptotic markers (p53, Bax, and Bcl-2) in photoinduced basal and squamous cell carcinoma. The study was performed on 24 patients diagnosed with these forms of cutaneous carcinoma localized on photoexposed regions: 14 cases of basal cell carcinoma (BCC) and 10 cases of squamous cell carcinoma (SCC), classified accordingly WHO 2003. The immunohistochemical study performed on the three proteins involved in the apoptotic process revealed certain specific features in their manner of expression, which do not correlate or respect the critical determinant rule (Bcl-2/Bax>1). Basal cell carcinoma expresses higher levels of Bcl-2, with a better prognosis, a less aggressive evolution, and no metastasis. Squamous cell carcinoma, on the other hand, expresses lower levels of Bcl-2, but the clinical outcome is more aggressive, the tumor has a faster evolution and may metastasize. P53 protein respects the profile given in literature data, having a higher score in squamous cell carcinoma versus basal cell carcinoma. According to the tumor localization on photo-aggressed sites, we have considered that ultraviolet rays play an important role in initiation of carcinogenesis through still occult mechanisms that may induce these particular or rather "bizarre" expressions of apoptotic markers.