Histopathological predictor of the progression from actinic keratosis to squamous cell carcinoma: quantitative computer‐aided image analysis

Abstract

BackgroundThe current histopathological classifications for actinic keratosis (AK) are subjective, and histopathological factors predicting the progression into invasive squamous cell carcinoma (SCC) remain unclear.ObjectivesTo quantitatively assess the histopathological findings of AK and to investigate the predisposing factors for malignant transformation of AK.MethodsA total of 502 AK specimens were retrospectively reviewed. The AK lesions were divided into the atrophic, intermediate, hypertrophic and bowenoid types. Histopathological features were quantitatively analysed using computer‐aided image analysis.ResultsThe epidermal thickness excluding the horny layer increased with statistical significance (P < 0.001) in order of atrophic, intermediate, hypertrophic and bowenoid type. The proportion of keratinocytic atypia was not significantly different among subtypes, except for the bowenoid type. Five of 498 cases were confirmed to develop into SCC. Bowenoid type, epidermal thickening and higher proportion of keratinocytic atypia were significantly associated with progression to invasive SCC in univariate analysis (OR = 12.571, 95% CI: 1.392–113.57; OR = 1.004, 95% CI: 1.001–1.007; OR = 1.069, 95% CI: 1.011–1.130, respectively). In multivariate analysis, only the proportion of keratinocytic atypia was an independent predisposing factor for progression to invasive SCC (OR = 1.069; 95% CI: 1.011–1.130).ConclusionsHistopathological subtypes based on the essential change of the epidermis well correlated with the actual epidermal thickness excluding the horny layer. The overall severity of keratinocytic atypia might be an independent risk factor for malignant transformation of AK.

Kesenjangan Modalitas Penunjang FNAB Terhadap Biopsi Eksisi pada Kasus Karsinoma Sel Skuamosa dengan Ukuran Tumor yang Besar: Laporan Kasus

“…Penilaian histologi KSS di lihat pada tingkat diferensiasi seluler. Pada well differentiated akan terlihat jelas perubahan yang terjadi pada membran dermis (Gambar 3) namun, ini berbeda dengan poorly differentiated dimana hanya sebagian yang baru berkembang (Chambers et al, 2020;Lee et al, 2021). Sehingga apabila pengambilan sampel dilakukan dengan FNAB pada posisi yang kurang tepat pada kasus KSS dengan poorly differentiated, maka gambaran yang akan di dapatkan akan seperti dermatofibroma (Gambar 4.…”

The frequency of cryotherapy for clinical remission of actinic keratosis correlated with the extent of keratinocytic atypia

“…1). 5 The level of involvement was examined and classified as none, to the infundibulum, or below the infundibulum. Pearson's correlation coefficient ( r ) was used to examine any associations between the histopathologic parameters and the frequency of cryotherapy.…”

Expression of p53, p63, p16, Ki67, Cyclin D, Bcl-2, and CD31 Markers in Actinic Keratosis, In Situ Squamous Cell Carcinoma and Normal Sun-Exposed Skin of Elderly Patients

“…An upregulation of this anti-apoptotic Bcl-2 protein is implicated in the progression from AK to SCC [12]. Additionally, Bcl-2 can label inflammatory cell infiltrate [31] and, within the complex process of cancer development, the extent of dermal infiltrate correlates significantly with keratinocyte atypia, mitotic count, and adnexal involvement [32].…”