A Clinicopathological and Immunohistochemical Comparison of Squamous Cell Carcinoma Arising in Scars Versus Nonscar SCC in Japanese Patients

Abstract

Squamous cell carcinoma (SCC) of the skin shows an indolent prognosis in general. However, the prognosis of SCC arising in a scar (scar carcinoma) is considered to be worse than that of SCC without any clinical history of injury (nonscar SCC). The aim of this study was to compare several indices, p53, Ki-67, E-cadherin, and beta-catenin, which are related to tumor behavior, between scar carcinoma and nonscar SCC clinicopathologically and immunohistochemically. The materials were from 10 cases of scar carcinoma and 10 cases of nonscar SCC. Clinicopathologically, the mean ages at diagnosis of scar carcinoma and nonscar SCC were 59.2 and 71.2, respectively. The most frequent anatomic site of scar carcinoma was the limbs. The most common cause of scars in our study was burns. The mean duration from the initial injury to the diagnosis of carcinoma was 30.5 years. Immunohistochemically, the mean labeling index (calculated as the percentage of positive cells) of p53 was 16.5 and 58.6 in scar carcinoma and nonscar SCC, respectively (P < 0.01, Welch test). The LI of Ki-67 was 19.1 in scar carcinoma and 52.1 in nonscar SCC (P < 0.01, Welch test). The rates of positivity of the other proteins, such as E-cadherin and beta-catenin, were similar between scar carcinoma and nonscar SCC. In this study, the follow-up time was short and the number of patients was small, and for these reasons it might not have been possible to obtain evidence that scar carcinoma is aggressive.