Expression of p53, D2-40 and α-smooth muscle actin in different histological subtypes of facial basal cell carcinoma

Although, generally BCC growths slowly and is minimally invasive, tumors developed in the head and neck region behave more aggressively with deep tissue invasion, recurrence and even local or distant metastases, causing significant morbidity or mortality. Recently, numerous studies have been conducted in order to identify new prognostic markers of BCC aggressiveness, but the results are not consistent. Thus, we were interested here in the immunohistochemical investigation of p53, D2-40 and alpha-SMA expression in the aggressive forms (eight infiltrative-morpheaform, six micronodular and six metatypical cases) versus superficial facial BCCs (five cases). As results, we first noticed that p53, D2-40 and alpha-SMA expression varied between different types of investigated BCCs. The highest reactivity was observed in metatypical subtype for the D2-40. p53 was mainly expressed in the micronodular BCC subtype and on overall, the tumor reactivity to this marker correlated directly with the reactivity for the other two used biomarkers. The infiltrative-morpheaform facial BCCs were peculiar more reactive to alpha-SMA. For all three investigated markers, regardless the histological subtype, the tumor reactivity was higher at the advancing edge, and in addition, at this level we noticed a D2-40 and alpha-SMA stromal reactivity for some cases of the more aggressive BCC subtype (peculiar in metatypical subtype). Thus, we concluded that in order to identify the most aggressive forms of facial BCCs it is useful to investigate these three markers, and this is even more important as they can all constitute therapeutic targets.