Abstract

Basal cell carcinoma (BCC) is the most common malignant skin tumor. BCC displays a different behavior compared with other neoplasms, has a slow evolution, and metastasizes very rarely, but sometimes it causes an important local destruction. Chronic ultraviolet exposure along with genetic factors are the most important risk factors involved in BCC development. Mutations in the PTCH1 gene are associated with Gorlin syndrome, an autosomal dominant disorder characterized by the occurrence of multiple BCCs, but are also the most frequent mutations observed in sporadic BCCs. PTCH1 encodes for PTCH1 protein, the most important negative regulator of the Hedgehog (Hh) pathway. There are numerous studies confirming Hh pathway involvement in BCC pathogenesis. Although Hh pathway has been intensively investigated, it remains incompletely elucidated. Recent studies on BCC tumorigenesis have shown that in addition to Hh pathway, there are other signaling pathways involved in BCC development. In this review, we present recent advances in BCC carcinogenesis.

Highlights

  • Basal cell carcinoma (BCC) is the most prevalent form of skin cancer, developing on sun exposed areas, especially in the fourth decade of life

  • We focused on recent advances related to the signaling pathways involved in BCC carcinogenesis

  • Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by mutations in the patched (PTCH)1 gene, PTCH2 gene and suppressor of the fused (SUFU) gene, which are negative regulators of the hedgehog (Hh) pathway [8]

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Summary

Introduction

Basal cell carcinoma (BCC) is the most prevalent form of skin cancer, developing on sun exposed areas, especially in the fourth decade of life. BCC is a slow-growing, locally invasive tumor, with a low capacity of metastatic spread [1,2]. It is commonly recognized that only 0.0028–0.55% of BCCs will metastasize [3]. Most cases of BCC are diagnosed in individuals with fair skin phototypes that carry out activities involving intense, intermittent or continuous exposure to UV [5]. The exposure to ionizing radiation, arsenic or coal tar derivatives increases the risk of developing a BCC. We focused on recent advances related to the signaling pathways involved in BCC carcinogenesis

Genes Involved in Nevoid Basal Cell Carcinoma Syndrome
Genes Involved in Sporadic BCC
Genes Linked to Therapy Resistance
Hedgehog Pathway—From Discovery to New Concepts
The Role of Inflammation and Immune Response in BCC Pathogenesis
Tumor Microenvironment in BCC
The Link between Inflammation and Hh Signaling
Crosstalk between Hh Signaling Pathway and Other Signaling Pathways in BCC
Hippo-YAP Pathway
EGFR Pathway
Vitamin D Pathway
P53 Pathway
Notch Pathway
Findings
Conclusions
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