Abstract
Actinic keratoses (AKs) are common dysplastic lesions resulting from chronic excessive ultraviolet exposure. Neither the clinical grade of thickness nor the histological grade of dysplasia seems valid predictors of aggressive potential of AKs. Instead, the mutational status in AKs appears to predict well the clinical course. TP53 gene mutations result in a non-functional protein resistant to degradation, thus immunohistochemical staining for p53 can suggest mutation status. Increased p53 was associated with progression from AK to squamous cell carcinoma. To investigate how the intensity of p53 staining (p53 staining index) varies according to body site, histological subtype and grade dysplasia of AKs. Secondly, we sought to investigate the distribution in the epidermal layers of non-functional p53 (zonal staining patterns). p53 staining index was greater than 50% in 90.7% of AKs. p53 staining index was significantly higher in older age (p < 0.0093) and in facial AKs compared to other body areas (p = 0.03). A significant correlation between p53 staining index and grade of dysplasia was observed (p = 0.006) and between p53 staining index and zonal p53 staining pattern (p = 0.003). No significant differences in p53 staining index among the various histological AK types were observed. No correlation between clinical and histological grade. All AKs, independently from their clinical appearance, should be treated but special attention is required for AKs on severely photodamaged skin on the face and in older patients.
Highlights
Actinic keratoses (AKs) are common dysplastic epidermal lesions resulting from chronic and excessive ultraviolet exposure [1]
Bakshi et al in a perspective study found that decreased E-cadherin and increased p53 were associated with progression from AK to non-melanoma skin cancer [1]
Mutations in the TP53 tumor suppressor gene is the most common genetic abnormality in human cancer and the majority of TP53 gene mutations result in a non-functional protein resistant to degradation, which accumulates in cell nuclei
Summary
Actinic keratoses (AKs) are common dysplastic epidermal lesions resulting from chronic and excessive ultraviolet exposure [1]. Immunohistochemical staining for p53 can suggest mutation status by marking non-functional p53 [23] Over the years, this technique evolved into an accurate surrogate reflecting the underlying TP53 gene mutation status of a tumor [23,24,25]. This technique evolved into an accurate surrogate reflecting the underlying TP53 gene mutation status of a tumor [23,24,25] This technique has been widely used in studying cancerogenesis in various tissues and organs and numerous studies support the validity of this technique in keratinocyte derived skin cancers [23, 26,27,28]. We sought to investigate the distribution in the epidermal layers of non-functional p53 (zonal staining patterns)
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