Clinical and Histological Features of Basal Cell Carcinomas A five-year experience in a dermatology clinic

International reports suggest a worldwide increase in the incidence of basal cell carcinomas. In Romania, there are poor epidemiological data regarding the prevalence of skin cancers and their histological subtypes. Our aim was to describe a population of patients diagnosed with basal cell carcinomas in a dermatology clinic, Romania and to characterize the histological features of the tumors. We enrolled in the study 352 patients, over a 5-year observation period and a cohort of 100 patients was recruited for the experimental study. The histopathological analysis was performed for 100 surgically excised tumors. The histochemical profile included the assessment of 20 samples for the enzymes NADH2 cytochrome c reductase, lactate dehydrogenase, leucine aminopeptidase, and ATP-ase. Immunohistochemical tests were performed in 10 samples and evaluated 4 tumoral biomarkers (p53, Bcl-2 Ki-67, PCNA). The ultrastructural features of 4 tumors were analyzed by electron microscopy. Our study revealed a high prevalence of two carcinogenic factors: positive history of radiotherapy or long-term sun-exposure. The histochemical results varied greatly depending on the tested enzyme, the tumoral subtypes (common, pigmented, metatypical), the inflammatory infiltrate and other factors. P53 and Bcl-2, two biomarkers of apoptosis, were predictive for tumoral progression. Our study revealed a great morphologic diversity of the tumors showing unique characteristics for each subtype. Histochemical, immunohistochemical and ultrastructural investigations provided a detailed description of the tumors, critical in the understanding of tumor progression, and highlighted potential biomarkers of severity (Bcl-2, p53, ki-67). In order to establish statistical relevant correlations, larger studies are needed.