ULTRASTRUCTURAL FEATURES OF THE MAIN CLINICAL VARIANTS OF BASAL CELL CARCINOMA, AS A FACTOR DETERMINING THE BIOLOGICAL BEHAVIOR OF THE TUMOR

Abstract

Histological variants of basal cell carcinoma (BСС) are characterized by a variety of structures depending on the location of the original tumor cells, their differentiation, the reaction of the surrounding tissue, the age of the patient, which causes a large number of histological classifications of the tumor. To evaluate the prognosis of the effectiveness of different treatment methods and the biological behavior of the ВCC, the clinical form and the corresponding histomorphological type of tumor are of great importance. Most of the primary foci of the ВCC are surface and micronodular (syn.: nodular) forms, rarely there is a scleroderm-like variant and extremely rarely fibroepithelioma of Pincus. Surface and micronodular forms of ВCC corresponding to the T1N0M0 characteristic (up to 2 cm in diameter) with a simple histological type of structure (multicentric, solidly compact) are regarded as tumors with a low risk of recurrence and progression. Materials and methods. Studying the features of the pathomorphological characteristics of the tumor and the frequency of various variants on the basis of an analysis of 223 ВCC biopsy specimens, we found that most often (54.7%) there was a solid type of tumor, less often -- superficial (12.7%), morphea (4.9% ), adenoid (10.9%), as well as ВCC with a piloidal (3.1%) and sebaceous (4.4%) differentiation. Among the biopsies analyzed in 6.8% of cases metatypic cancer was found. Conclusions: The histological structure of the tumor can determine its biological behavior and have prognostic significance. Thus, pronounced primitive angiogenesis, infiltrating growth and active stroma formation testify to tumor aggressiveness and clinically most correspond to the recurring macronodular and infiltrative clinical forms of BCC. The tumor is most aggressive in its basosquamous transformation, manifested in the emergence of two components of the tumor complex in the area of dyskeratosis and pseudoepitheliomatous hyperplasia of the epidermis: basal cell carcinoma and highly differentiated cancer, which corresponds to the formation of metatype skin cancer.