الفهرس 
Non melanoma skin cancerOnly 14 pages are availabe for public view
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Abstract
Non melanoma skin cancer (NMSC) is the most frequently occurring human malignancy. It is encountered all over the world, particularly in areas with high exposure to its primary risk factor, sunlight. There are many environmental factors that contribute to the development of NMSC. These factors include ultraviolet radiation (UVR), ionizing radiation, exposure to arsenic, infection with human papilloma virus (HPV), and tobacco use. Development of malignancy is not limited to these factors and can also occur in chronic inflammatory and immunosuppressive states. Early identification of suspicious lesions is significant because the various therapies available are most effective for localized disease.
Dendritic cells (DC) are the most potent antigen-presenting cells and are critical for the generation of adaptive immune responses. DC subsets with unique functions and phenotypic characteristics play distinct roles in eliciting key immune responses. One major population, myeloid DC, contains further subtypes, including Langerhans cells (LC), interstitial DC and monocyte-derived DC that have unique phenotypic features. CD1a is one of the unique proteins that identify the prototypic and first-described DC subset, LC. Although first isolated from skin; CD1a expressing DC is now known to be distributed widely in many other sites including lung, tonsil, gastrointestinal and genital tracts.
Currently, ten major characteristics of cancer have been universally recognized, including unlimited multiplication, evasion from growth suppressors, promoting invasion and metastasis, resisting apoptosis, stimulating angiogenesis, maintaining proliferative signaling, elimination of cell energy limitation, evading immune destruction, tumor enhanced inflammation, genome instability and mutation. Although researchers now have an understanding of most characteristics of cancer, the characteristics regarding cancer formation, remains unknown. So, the assessment of immunohistochemical expression of CD1a in NMSC is proposed as a challenge way to estimate the risk of disease in order to provide additional information influence decisions about treatment in order to improve health outcomes.
The aim of the work is to assess density of Langerhans dendritic cells in non-melanoma skin cancer using CD1a immunohistochemical method.
This is a case-control study that included 41 cases with clinical and histopathological diagnosis of NMSC; the patients were transferred to Surgical Department for excision with safety margins. Another 16 case of age and sex-matched subjects attending Plastic Surgery Clinic, were taken as controls.
The mean age of the studied cases ranged from 16 to 91 years old with a mean of 58.93 ±15.29 and a median of 62 years old. Among the studied patients, 23 (56.15%) were males and 18 (43.9%) were females with 1:28:1 a male to female ratio. Regarding the tumor type a number of 26 (63.4%) as were BCC and 15 (36.6) were SCC. The majority of cases were facial 36(87.8%) while only three cases (7.4%) were trunkal and one case on the sole and one case on the leg. The mean tumor size was 3.183 ± 3.03with a range from (0.3 to 15) and median of 2 cm. The margin was free in 29 (70.8%) cases and involved in 12 (29.2%) cases. The SCC was well differentiated in 2 (13.3 %) cases, moderately differentiated in 8 (53.4%) cases and poorly differentiated in 5 cases
Summary
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(33.3%). Out of the total SCC a number of 4 cases (26.7%) were classified as T1 and five cases (33.3%) were T 2 and 6 cases (40%) were T3.
There were insignificant differences between malignant cases and control regarding age and sex (P value >0.05).
Langerhans dendritic cells highlighted by CD1a were present in epidermis of all control cases,While they were present in malignant cases 33 out of 41 (80.5) without significant differences compared to control (p= 0.09). Furthermore, positivity of CD1a was also identified in adjacent epidermis over malignant cases in 80.6% (33/41) without significant difference from control (p value= 0.09). On the other hand, the density of dendritic cells percentage was high in normal compared to malignant cases (p=0.001). And in adjacent epidermis over malignant cases (p=0.007) with significant difference.
The positive CD1A cases was higher in BCC (72.7) comparing to SCC (27.3%) P= 0.035. Furthermore, CD1A positivity was significantly higher in malignant lesions arising in the face (93.9%) compared to other sites (6.1%). On the other hand, CD1a Expression was not correlated with other parameters such as age, gender, size, margin, grade of SCC and TS Stage. However the density of dendritic cells (percentages of CD1a) was not correlated with studied parameters.