| Abstract: |
Actinic keratosis (AK) is a well-established precancerous skin lesion that has the potential to progress to squamous cell carcinoma (SCC). SCCs of the skin are the most prevalent keratinocyte-derived tumours, second to basal cell carcinomas (BCCs)(3). Clinically AKs appear primarily on chronically sun-exposed areas, and sites adjacent to AKs may contain significant histological alterations, suggesting extensive pre-neoplastic alterations in sundamaged skin . Studies have been carried out in order to determine the parameters that have prognostic significance in predicting those tumors which have more aggressive behavior.Materials and Methods: To investigate the regulation of apoptosis and proliferation in actinic keratosis cases, we examined the expression of bcI-2. p53, and Ki-67 using immunohistochemical staining. Thirty patients with AK and 10 healthy persons as a control .We examine the potential relationship between connective tissue degeneration and molecular alterations in epithelial cells without evident morphologic changes, 30 cases of AK (10, grade I; 10, grade II; 10, grade III), divided into three grades according to the proportion of dermal elastosis (in grade I, up to 30% of collagen degeneration; in grade II, 30–60%; in grade III, more than 60%), were immunohistochemically analyzed for the expression of Ki67, p53,bcl-2Results: The increase in the solar elastosis grade was associated with an increase in positive cell numbers for all analyzed markers. Basal expression predominated in the lesions with low and moderate levels of connective tissue degeneration, while a basal and suprabasal expression pattern was prevalent in the lesions with high degeneration. In grade I and II lesions, proliferation marker, Ki67, expression was found to be significantly associated with the proapoptotic marker p53, while in grade III lesions, its expression was correlated with the anti-apoptotic marker, bcl-2.Conclusions: These results demonstrate that the epithelial expression of apoptotic, cell proliferation, and structural proteins is augmented with the increase of the solar elastosis grade. Thus, the grade of solar elastosis could be a helpful morphologic marker in the assessment of neoplastic changes in sun-damaged skin.
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