Molecular Markers in Cutaneous Squamous Cell Carcinoma

Anthony P Tufaro,Anne C Fischer,Jim C.-M Chuang,Tony C Chuang,Alice Chuang,Nijaguna Prasad

doi:10.1155/2011/231475

Abstract

Nonmelanoma skin carcinoma (NMSC) is the most frequent cancer in the USA with over 1.3 million new diagnoses a year; however due to an underappreciation of its associated mortality and growing incidence and its ability to be highly aggressive, the molecular mechanism is not well delineated. Whereas the molecular profiles of melanoma have been well characterized, those for cutaneous squamous cell carcinoma (cSCC) have trailed behind. This importance of the new staging paradigm is linked to the ability currently to better clinically cluster similar biologic behavior in order to risk-stratify lesions and patients. In this paper we discuss the trends in NMSC and the etiologies for the subset of NMSC with the most mortality, cutaneous SCC, as well as where the field stands in the discovery of a molecular profile. The molecular markers are highlighted to demonstrate the recent advances in cSCC.

Highlights

Nonmelanoma skin carcinoma (NMSC) is the most frequent cancer in the USA and worldwide [1]; it has been increasing in overall incidence since the 1960’s at a rate of 3–8% per year [2]
The incidence of basal cell carcinoma (BCC) exceeds cutaneous squamous cell carcinoma (cSCC) by a 5 : 1 ratio, cSCC is associated with the burden of mortality with a disease-specific yearly mortality rate of 1% per year as reported in the early 1990’s [4]
The high incidence of cSCC and BCC is caused by the mutagenic effects of ultraviolet (UV) light which is intensified by geographic latitude [1, 7]. cSCC and BCC are more common in fair skinned and anatomic sites exposed to the sun, such as head, neck, and extremities: head and neck is the most common site

Summary

Introduction

Nonmelanoma skin carcinoma (NMSC) is the most frequent cancer in the USA and worldwide [1]; it has been increasing in overall incidence since the 1960’s at a rate of 3–8% per year [2]. Immunocompromised states are associated with a marked escalation of cSCC of up to 64–250 times greater than that in the general population compared to the 10-fold increased risk in BCC, causing a reversal of the typical ratio in immunocompetent individuals from 5 : 1 to a range between 1 : 1.8 and 1 : 15 [10, 11]. In solid organ transplant patients, cSCC tumors tend to be numerous, exhibit a strong propensity to recur, and metastasize at a high rate regardless of lesional size [12]. Cutaneous genetically inherited skin conditions that have a known propensity of risk for developing cSCC are albinism, xeroderma pigmentosum, and epidermodysplasia verruciformis [5, 16, 17]

Staging

Pathogenesis

Findings

Conclusions