Ki-67 antigen expression and growth pattern of basal cell carcinomas

The expression and location of the Ki-67 antigen was investigated in 62 basal cell carcinomas (BCC) using immunostaining techniques (PAP and APAAP) on cryostat sections. The tumor samples were classified into three groups according to microarchitecture (nodular, superficial or fibrosing). The Ki-67 growth fraction displayed great variation between tumors belonging to the same group (nodular type, 7-67%; superficial type, 18-49%; fibrosing type 4-33%). In nodular and superficial BCC formations Ki-67 reactivity was confined either to the nuclei of three to five rows of peripheral cells, or Ki-67-positive nuclei were scattered in the central as well as in the peripheral parts of the tumor strands. The staining patterns varied in an individual tumor. Areas with a high Ki-67 labelling index often occurred adjacent to rather quiescent strands, suggesting that an individual tumor is not in a uniform state of proliferation. So far there are no experimental findings on the regulation of proliferative activity in BCCs. In view of the fact that BCCs are rather slow-growing tumors, the large Ki-67 growth fractions indicate a prolonged duration of the cell cycle or a considerable continuous loss of cells. As the microarchitecture of BCCs is much more complex than would be expected from the location of their Ki-67-positive cells, the growth pattern is probably determined to a high degree by the adjacent connective connective tissue (physical properties and texture of collagen and elastic fibres, enzyme activity of fibroblasts).