Basal Cell Carcinoma Patients Research Articles

Factors Influencing Margin Clearance and the Number of Stages of Mohs Micrographic Surgery in Basal Cell Carcinoma: A Retrospective Chart Review

Factors Influencing Margin Clearance and the Number of Stages of Mohs Micrographic Surgery in Basal Cell Carcinoma: A Retrospective Chart Review

Activity of oxidative processes and the state of the redox regulating system in tumor tissue in skin cancer

Purpose of the study. To study the intensity of lipid peroxidation (LPO) and the activity of antioxidant protection components in tumor tissues, peritumoral zone and conditionally healthy skin tissue in basal cell carcinoma, depending on the type of tumor growth, gender of patients, and the presence of concomitant diseases.Materials and methods. Tissues from 34 patients with basal cell carcinoma (BCC) were studied, including 17 women (10 with superficial tumor growth and 7 with solid growth) and 17 men (5 and 12 patients, respectively). We used skin flaps obtained during operations on 12 men and 10 women without malignant pathology (“norm”) as a comparison material. The content of malondialdehyde (MDA), diene conjugates (DC), superoxide dismutase (SOD) activity and total peroxidase activity (TPA) were determined. Statistical processing of the results was carried out using the Statistica 10.0 program.Results. In women, the level of MDA was increased in all tissues: with superficial growth of BCC by 2.1–2.5 times (p ≤ 0.05), with solid growth by 1.6–2.1 times (p < 0.05) relative to the “norm”. In men with superficial growth, an MDA increase by 3.2 and 3.1 times in tumor tissue and conditionally healthy tissue was observed (p < 0.02), and no increase in MDA in the tumor was detected in 11 of 12 patients with solid growth. An increase in DC (on average 2–5 times) in BCC patients with concomitant hypertension and diabetes mellitus was observed mainly in women. Activation of SOD in tumor tissue, to a greater extent in men (2.4 times with superficial growth and 1.7 times with solid growth, p < 0.05 relative to conditionally healthy tissue), can be considered as a mechanism of antiradical protection of the tumor.Conclusions. An increase in the level of MDA in BCC was observed in tumor and nearby tissues in women with both types of growth, in men only with superficial growth. Analysis of individual characteristics of LPO indicators in patients with skin carcinoma revealed a dependence of the severity of the increase in MDA and especially DC on the presence of concomitant pathology (hypertension, diabetes mellitus).

Investigation of Genetic Association Between a High Activity Variant of Cathepsin G and Risk for Basal Cell Carcinoma.

Cathepsin G (CTSG) has been identified as an inhibitor of breast, bladder, and colorectal cancers. The G allele of the N125S (A/G, rs45567233) functional polymorphism of the CTSG gene confers increased serum CTSG activity and has been associated with cardiovascular and neurovascular diseases. This study examined the possible correlation between the pathogenesis of basal cell carcinoma (BCC) and the functional polymorphism CTSG N125S. A total of 197 DNA samples were examined, comprising 98 BCC patients and 99 control samples of Greek origin. The CTSG N125S polymorphism was molecularly genotyped using PCR amplification, followed by enzyme digestion, and agarose gel electrophoresis of the amplified DNA fragments. There was no statistically significant difference in the genotypic and allelic frequencies between the patient and the control groups. There is no association between the CTSG N125S polymorphism and pathogenesis of BCC.

Basal cell carcinoma-a clinical indicator of immunosuppression.

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are skin-derived carcinomas. The literature strongly connects SCC with acquired immunosuppression. Current data regarding BCC's association with immunosuppressive comorbidities are vague. The primary objective of this study was to establish the correlations between BCC and immunosuppressive comorbidities of patients. Materials and methods: We conducted a retrospective cohort study on 275 patients with a histopathological proven diagnosis of BCC from October 2019 to October 2023. Demographic data, BCC characteristics, and patients' comorbidities were analyzed. Comorbidities were classified as non-immunosuppressant and immunosuppressant (primary and secondary immunodeficiencies). We recorded 292 BCCs from 275 patients (142 females, 133 males), with equally distributed skin phototypes. 66.44% of the BCCs were detected in patients with various comorbidities (p < 0.001), of which 81.44% had immunosuppressive comorbidities (p < 0.001). All the immunosuppressive comorbidities were secondary and included diabetes mellitus (47.55%), history of solid or hematogenous cancer in the last 5 years (26.57%), chronic kidney disease (8.39%), chronic infections (9.09%), and antirheumatic immunosuppressive therapies (8.39%) (p < 0.001). BCC patients with immunosuppressive comorbidities did not develop larger BCCs (p = 0.2577) or more aggressive subtypes (p = 0.4269) and BCC did not arise earlier in their life (p < 0.001). BCC on the nasal pyramid was frequent in cancer history patients (p = 0.008). The ulcerated form of BCC is more confined to patients with chronic kidney disease (p = 0.006). Multiple BCCs are more frequent in patients with secondary immunodeficiencies (p = 0.027). BCC represents a clinical indicator of secondary immunodeficiency. Further research should establish if cancer screening campaigns may be beneficial in BCC patients.

PTCH1 gene variants rs357564, rs2236405, rs2297086 and rs41313327, mRNA and tissue expression in basal cell carcinoma patients from Western Mexico.

Basal cell carcinoma (BCC) represents about 80% of all cases of skin cancer. The PTCH1 is a transmembrane protein of the Sonic Hedgehog signaling pathway that regulates cell proliferation. Genetic variants in PTCH1 gene have been previously described in association with BCC development. In addition, PTCH1 mRNA and protein expression analysis are also significant to understand its role in skin cancer physiopathology. An analytical cross-sectional study was performed, and a total of 250 BCC patients and 290 subjects from the control group (CG) were included, all born in western Mexico. The genotypes and relative expression of the mRNA were determined by TaqMan® assay. The protein expression was investigated in 70 BCC paraffin-embedded samples with PTCH1 antibodies. Semi-quantitative analysis was performed to determine the expression level in the immunostained cells. We did not find evidence of an association between PTCH1 rs357564, rs2297086, rs2236405, and rs41313327 genetic variants and susceptibility to BCC. Likewise, no statistically significant differences were found in the comparison of the mRNA level expression between BCC and CG (p > 0.05). The PTCH1 protein showed a low expression in 6 of the analyzed samples and moderate expression in 1 sample. No association was found between genetic variants, protein expression, and demographic-clinical characteristics (p > 0.05). The studied PTCH1 variants may not be associated with BCC development in the Western Mexico population. The PTCH1 mRNA levels were lower in patients with BCC compared to the control group, but its protein was underexpressed in the tissue samples.

THE EPIDEMIOLOGY OF BASAL CELL CARCINOMA AT THE NATIONAL HOSPITAL OF DERMATOLOGY AND VENEREOLOGY IN THE PERIOD 2017-2022

Objectives: To examine the situation and characteristics of basal cell carcinoma (BCC) and to follow up on and evaluate the effectiveness of treatment methods at the National Hospital of Dermatology and Venereology (NHDV) during the period 2017-2022. Material and methods: Cross-sectional study using data from all patients diagnosed with BCC and treated at NHDV from January 2017 to December 2022. Results: In the six years from 2017 to 2022, 1133 patients with skin cancer were treated at NHDV, of whom 765 patients had BCC, accounting for 67.5%. The mean age of BCC patients gradually decreased from 65.01 years old in 2017 to 60.2 years old in 2022, and the proportion of patients under 60 years old increased statistically over the years (p &lt; 0.01). Among the 387 BCC patients treated at NHDV from January 2020 to December 2022, 317 patients underwent Mohs surgery, accounting for 81.9%, and no recurrence was recorded. Meanwhile, 70 patients underwent wide-local excision (18.1%), and five cases of recurrence were recorded during follow-up. Conclusion: Basal cell carcinoma is the most common among skin cancers, and patients tend to be younger. Mohs surgery yields good results with the highest cure rate, optimizing the preservation of surrounding healthy skin tissue, maintaining function and aesthetics, and minimizing the recurrence rate. Received 02 July 2023Revised 20 September 2023Accepted 26 November 2023

Clinical Characteristics of Basal Cell Carcinomas of the Scrotum: An Institutional Retrospective Review

Objective. To analyse the clinical and pathologic features, discuss therapeutic strategies, and possibly cause and identify prognostic factors of scrotal basal cell carcinoma (BCC) in Chinese patients. Materials and Methods. Between January 2012 and December 2022, 12 patients with scrotal BCC were diagnosed and treated at our institution. A review was conducted based on the clinical characteristics, pathology slides, and tissues of these patients. Results. The median patient age was 69.26 ± 11.23 years. The skin lesions presented as red papules, blue-grey polypoid nodules, erythematous patches, brownish plaques, and so on. All patients were treated using wide excision, but the margins varied from 0.5 cm to 2 cm. HPV infection was checked in all lesions, with 4 out of 12 testing positive for P16 and 1 for HPV16 DNA. We found mottled positive expression of P16 in the cytoplasm and membrane. One patient developed left inguinal lymph node metastasis and was successfully treated using bilateral inguinal lymphadenectomy. The rest recovered well without relapse. Conclusions. BCC of the scrotum is rare, but long-term surveillance is recommended for BCC patients, and whether genital HPV infection is a noteworthy feature for these patients remains under investigation.

Incidence of malignant eyelid tumors: A 6-year period review (2015–2021)

Abstract Background: Basal cell carcinoma (BCC), the most common malignant tumor, accounts for 85%–95% of cases of eyelid malignant tumors. Demographic factors such as age, gender, tumor location, and subtype play a crucial role in epidemiological knowledge. We investigated eyelid BCC diagnosis and treatment at the Department of Ophthalmology in Centro Hospitalar de Setúbal (CHS). Methods: A retrospective study was conducted on patient cases with suspected eyelid epithelial tumors who underwent excisional biopsy surgery. The study included data from the CHS database between 2015 and 2021. Data collection and subsequent analysis were based on histopathological results. Results: In our study, were analyzed a total of 47 tumor cases, with 68.1% located on the lower eyelids and 31.9% on the upper eyelids. Among these cases, 25 (53.2%) were classified as benign, while 22 (46.8%) were identified as malignant eyelid tumors. BCCs accounted for 90.9% of all malignant cases, with an average age of 71.7 ± 16.6 years. The nodular subtype was the most prevalent, followed by infiltrative and superficial subtypes. Superficial BCC patients were older than infiltrative BCC patients (median age = 69.5 years vs. 61.5 years). BCC primarily affected the lower eyelids compared to the upper eyelid, and there was a slight female predominance (n = 11). All diagnosed BCCs correlated with sun-exposed regions. Conclusions: Timely intervention is crucial for reducing morbidity. These findings emphasize the need for improved registration and notification systems to enhance the prevention and treatment of eyelid BCCs. Furthermore, despite advancements in ultraviolet-blocking technologies, further development of sunscreen specifically formulated for ocular use remains necessary to reduce the incidence of eyelid tumors.

Hedgehog Inhibitors Beyond Clinical Complete Response in Basal Cell Carcinoma: Should I Stop or Should I Go?

In advanced basal cell carcinoma (BCC), the issue of whether Hedgehog inhibitors (HHIs) should be stopped or not after clinical complete response (cCR) achievement remains an unmet clinical need. We conducted a retrospective, multicenter study across 7 Italian dermato-oncology units including patients with BCC who continued vismodegib after cCR between 2012 and 2019. We assessed the relationship between the duration of vismodegib intake (days to cCR [DTCR], days to stop after cCR [DTS], total treatment days [TTD]), and disease-free survival (DFS). Reasons to stop vismodegib were (R1) toxicity and (R2) disease recurrence. The relationship between DTCR, DTS, TTD, and DFS in the whole population and in R1 subgroup was assessed by Pearson's correlation coefficient (P < .05) and Bayesian statistics (BF10). Sixty-eight BCC patients with a median (m) age of 75.5 years (39-100) were included. Most patients were male (N = 43, 63%), without Gorlin syndrome (N = 56, 82%) and with head and neck area as primary site (N = 51, 75%). After cCR, out of 68 patients, 90% (N = 61/68) discontinued vismodegib: 82% (N = 50/61) due to toxicity (R1), and 18% (N = 11/61) due to recurrence (R2). Conversely, 10% (N = 7/68) continued vismodegib until last follow-up. In the whole population (N = 68), cCR was achieved with a mDTCR of 180.50 days. DFS showed a significant correlation with DTS (P < .01, BF10 = 39.2) and TTD (P < .01, BF10 = 35566), while it was not correlated to DTCR (BF10 < 0.1). The analysis of R1 subgroup (N = 50) confirmed these results. DFS correlated with DTS in all recurrent patients (N = 38, r = 0.44, P < .01) and in the recurrent patients who stopped vismodegib for toxicity (N = 26, r = 0.665, P < .01). DFS was longer when vismodegib was maintained for >2 months after cCR (mDFS > 2 months, N = 54 vs. ≤ 2 months, N = 14: 470 vs. 175 d, P < .01). Our retrospective results suggest that HHIs should be continued after cCR to improve DFS in BCC.

Preoperative evaluation of high-risk basal cell carcinoma with line-field confocal optical coherence tomography (LC-OCT) reduces Mohs micrographic surgery stage number: A case-control study

BackgroundMohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line field confocal optical coherence tomography (LC-OCT) is expected to reduce MMS stages number. Objectiveto investigate the effectiveness of LC-OCT preoperative evaluation of high-risk BCC margins in reducing the number of MMS stages to achieve tumor clearance. Patients and methodshigh-risk BCC patients undergoing MMS at Policlinico A. Gemelli Foundation, IRCCS – Rome during January 2018 – December 2022. The LC-OCT group included patients undergoing preoperative lateral tumor margin demarcation by clinical, dermoscopic, and LC-OCT examination; patients in the control group underwent preoperative lateral tumor margin demarcation by clinical and dermoscopic examination only. LC-OCT imaging was compared to MMS histopathological sections. Results63 facial high-risk BCCs from 60 patients, mean age of 68.3 years (SD 11.9). The LC-OCT and the control group included 22 and 41 BCCs, respectively. LC-OCT imaging showed almost perfect agreement with histopathology for low- versus high-risk of recurrence BCC histopathological subtypes discrimination (Cohen’s kappa 0.88). We reported a significant difference in the mean number of MMS stages between the LC-OCT and the control group (1.23 ± 0.43 SD, and 1.89 ± 1.05 SD, respectively; p-value =0.007). At univariate regression analysis, LC-OCT preoperative mapping of BCC tumor margins significantly reduced patients’ risk of undergoing >1 MMS stage (crude odds ratio [ORc]: 0.3 95% CI 0.1–0.8, p-value =0.032). ConclusionLC-OCT preoperative evaluation of high-risk BCC margins significantly reduced the number of MMS stages to achieve tumor clearance.

Photodynamic Therapy in Treating a Subset of Basal Cell Carcinoma: Strengths, Shortcomings, Comparisons with Surgical Modalities, and Potential Role as Adjunctive Therapy.

Basal cell carcinoma (BCC) is the most common skin cancer, for which there are multiple treatment options, including the gold standard Mohs micrographic surgery (MMS), surgical excision, electrodesiccation and curettage, radiation therapy, cryosurgery, and photodynamic therapy (PDT). While PDT is currently approved for treating actinic keratosis, it has been used off-label to treat BCC patients who may not tolerate surgery or other treatment modalities. We present a review of the efficacy of these modalities and describe important considerations that affect the usage of PDT and MMS. ALA-PDT and MAL-PDT are both efficacious treatment options for lower-risk BCC that can serve as non-invasive alternatives to surgical excision with favorable cosmetic outcomes in patients unsuitable to undergo surgery. In particular, PDT may be considered an adjuvant for the prevention and treatment of BCC lesions in patients with some genetic syndromes such as Gorlin syndrome, and in combination with surgical excision in lesions presenting in certain locations. Limitations to PDT include lack of margin control to prevent recurrence, pain, and cost of certain photosensitizers. Future studies should investigate the role of PDT as adjunctive therapy, standardization of protocols, and causes and ways to address recurrence following PDT treatment.

Multiple aggregated yellow-white globules are a major dermoscopic sign of basal cell carcinoma regardless of their histological subtype.

Multiple aggregated yellow-white globules (MAY globules) have been recently described as dermoscopic structures of high specificity associated with high-risk non-pigmented basal cell carcinoma (BCC). To evaluate the diagnostic accuracy of MAY globules in a cohort of pigmented and non-pigmented BCC of all histological types. This was a retrospective case-control study. Dermoscopic and clinical images were all histopathologically confirmed as BCCs of patients seen consecutively at dermatology consultation. Control cases were benign or malignant tumours randomly selected from the database of 8,250 patients. A total of 389 BCCs were included. MAY globules were present in 192 (49%) cases in the BCC group and in only 25 cases in the control group (6,4%). The odds ratio for the diagnosis of BCC was 14.2 (95%CI: 9.62-20.95]). The presence of MAY globules was significant in three histological subtypes, including superficial BCCs. This study shows that MAY globules are a major dermoscopic sign for the diagnosis of BCC, regardless of their histological subtype and their pigmentation.

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion-Findings and Perspectives.

Basal cell carcinoma (BCC) is a malignant tumor with a rising incidence and is the beneficiary of several innovative evaluation techniques. Histopathology remains the gold standard for assessment, having the possibility of addressing multiple high-risk factors such as perineural invasion (PNI). The current study included a number of 244 BCC patients and targeted the identification of positive PNI and its suggestive signs, and whether they correlated or not with other high-risk tumor signs. PNI was found in 20.1% of patients, with 30.7% of patients having perineural chronic inflammation (PCI), which is a suggestive sign of PNI. PNI was also found in larger tumors, with deeper Clark levels, in high-risk BCCs and high-grade tumors. PNI and PCI are both important for pathology reporting, aiding in treatment choice and further patient management, with possibly positive outcomes concerning morbidity and mortality.

CemiplimAb-rwlc survivorship and epidemiology (CASE): A prospective study of safety and efficacy of cemiplimab in patients with advanced basal cell carcinoma in a real-world setting.

TPS9614 Background: Basal cell carcinoma (BCC) is the most common form of non-melanoma skin cancer in the United States. Surgical excision is the standard treatment, with &lt; 1% of cases progressing to locally advanced or metastatic disease. Hedgehog pathway inhibitors (HHIs) are the first-line therapy for advanced BCC (aBCC); the US Food and Drug Administration and European Medicines Agency have approved the use of cemiplimab (a programmed cell death-1 inhibitor) in advanced BCC (aBCC) patients previously treated with (or are inappropriate for) HHI. Limited real-world data exist on the clinical characteristics, disease management and progression, and survivorship of patients with aBCC. The ongoing C.A.S.E. study aims to evaluate the efficacy, safety, disease evolution, survivorship, and patient reported outcomes (PRO) in patients treated with cemiplimab in the real-world setting. Methods: This trial in progress (NCT03836105) aims to describe the effectiveness and safety of cemiplimab 350 mg administered every 3 weeks for treatment of patients with aBCC in real-world clinical settings. Up to 100 adult patients with aBCC who are prescribed commercially available cemiplimab from ~65 study sites in the United States will be included. The duration of follow-up will be 24 months. Endpoints for this study relate to real-world efficacy, including overall survival; progression-free survival; objective response rate, (partial or complete response); and disease control rate, defined as the percentage who do not progress for ≥ 6 months; Time to response, duration of response, time to treatment failure, and disease-specific death will also be assessed. Real-world safety outcomes will also be captured, including immune-related adverse events, infusion-related reactions, and serious adverse events. Patient selection criteria and treatment patterns will be analyzed using descriptive statistics. This study also aims to describe the patient experience of real-world treatment with cemiplimab. PROs including global quality of life, functioning, and symptoms will be captured at baseline and follow-up visits via the EORTC QLQ-C30 and the Skin Care Index. Recruitment for this trial is ongoing. Clinical trial information: NCT03836105 .

Abstract CT115: Treatment of skin tumors with intratumoral interleukin 12 gene electrotransfer in the head and neck region: A phase I clinical trial

Abstract Immunotherapies with monoclonal antibodies (checkpoint inhibitors) are currently being intensively researched and have led to excellent response in many cases in various tumors. Another potential approach to immunotherapy is the targeted intratumoral administration of interleukin 12 (IL -12), a cytokine with proven anti-tumor activity. Due to its immunomodulatory effect, it can be used as an immunostimulatory component for in situ vaccination of local ablative therapies. We have developed a phIL12 plasmid without antibiotic resistance markers using a transgene for the human IL -12 p70 protein. The plasmid can be introduced intratumorally by gene electrotransfer. In gene electrotransfer, electrical pulses are applied to the tumor to deliver the plasmid DNA into the cells. Based on nonclinical studies of safety, pharmacokinetics, pharmacodynamics, tolerability, and immunogenicity, a phase I clinical trial of phIL12 gene electrotransfer was conducted (ISRCTN15479959, ClinicalTrials NCT05077033). The primary objective of the study is to evaluate the safety and tolerability of phIL12 gene electrotransfer in the treatment of basal cell carcinoma in patients with operable tumors of the head and neck. The study, an exploratory, dose-escalating Phase I study, will enroll 9 patients in three dose-escalating cohorts. Treatment consists of plasmid injection followed by application of electrical pulses to the tumors. Patients are monitored for 30 days, with tumors removed if a complete response is not achieved. To date, two cohorts of patients have completed the study. No adverse effects or treatment-related toxicities have been observed, and treatment has been well tolerated by patients. The results of this study will provide the basis for the use of phIL12 gene electrotransfer as adjuvant therapy to local ablative therapies to enhance their local effect and elicit a systemic response. Citation Format: Gregor Sersa, Maja Cemazar, Crt Jamsek, Primoz Strojan, Tanja Jesenko, Masa Bosnjak, Ales Groselj. Treatment of skin tumors with intratumoral interleukin 12 gene electrotransfer in the head and neck region: A phase I clinical trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT115.

Differential Expression of ATM, NF-KB, PINK1 and Foxo3a in Radiation-Induced Basal Cell Carcinoma.

Research in normal tissue radiobiology is in continuous progress to assess cellular response following ionizing radiation exposure especially linked to carcinogenesis risk. This was observed among patients with a history of radiotherapy of the scalp for ringworm who developed basal cell carcinoma (BCC). However, the involved mechanisms remain largely undefined. We performed a gene expression analysis of tumor biopsies and blood of radiation-induced BCC and sporadic patients using reverse transcription-quantitative PCR. Differences across groups were assessed by statistical analysis. Bioinformatic analyses were conducted using miRNet. We showed a significant overexpression of the FOXO3a, ATM, P65, TNF-α and PINK1 genes among radiation-induced BCCs compared to BCCs in sporadic patients. ATM expression level was correlated with FOXO3a. Based on receiver-operating characteristic curves, the differentially expressed genes could significantly discriminate between the two groups. Nevertheless, TNF-α and PINK1 blood expression showed no statistical differences between BCC groups. Bioinformatic analysis revealed that the candidate genes may represent putative targets for microRNAs in the skin. Our findings may yield clues as to the molecular mechanism involved in radiation-induced BCC, suggesting that deregulation of ATM-NF-kB signaling and PINK1 gene expression may contribute to BCC radiation carcinogenesis and that the analyzed genes could represent candidate radiation biomarkers associated with radiation-induced BCC.

Abstract 6548: Bioinformatic characterization of dendritic and T cell subpopulations in the tumor microenvironment across different cancer types by single-cell RNA-Seq analysis

Abstract Although the development of single-cell RNAseq (scRNAseq) has improved the knowledge of the tumor microenvironment (TME), there is not a clear understanding of specific cell subtypes, markers that define these cell populations, nor the interaction between them. Previously, we showed that inflammasome activation is correlated with antitumor responses triggered by immune checkpoint blockade (ICB). This highlights a central role for TMEM176B, mostly expressed in myeloid cells, that impairs the recruitment of cytotoxic immune cells in the TME by inhibiting NLRP3 inflammasome activation. Still, the roles of the different subsets of myeloid and T cells in the TME and to what extent they are connected remain controversial. Here, we used scRNAseq data from human tumors to identify and characterize cDC2, Th17 and exhausted CD8+ T cell subpopulations in cancer. Five scRNAseq data sets of melanoma, basal cell carcinoma, breast, lung, colorectal, and ovary cancer patients were integrated, accounting for 382,019 immune cells in total. We applied and compared different bioinformatic tools for scRNASeq data normalization and data sets integration to find conserved immune cell populations across samples, data sets, and cancer types. Then, we evaluated different parameters using well-established methods for clustering and cell type classification to identify subtypes of DCs and T cells in the integrated data. We combined automatic methods with manual analysis of cluster markers to improve robustness and confidence in the cell populations identified. Three clusters of cDC2 were defined and characterized using different scRNAseq analysis tools for pathway enrichment analysis and transcription factors (TF) activation prediction. We found a subset of inflammatory cDC2 with high gene expression of IL1B and NLRP3, in contrast with another cluster characterized by high expression of TMEM176B and CD14. A third cluster showed an intermediate transcriptomic profile. The TMEM176B+ CD14+ cluster was characterized by the activation of JAK-STAT and hypoxia pathways, and the TF FOXL2, ETS2, and ESR2. The NLRP3+ IL1B+ cluster showed more activation of MAPK, Trail, and PI3K pathways, and the TF CEBPE. Moreover, the activation of TNFα and NFkB signaling pathways was found in both clusters. In addition, a conserved population of Th17 cells in the integrated data was observed. Th17 cells were heterogeneous, making the subpopulations and transcriptome signature difficult to define. Further analysis is being performed to identify Th17 subsets and their potential interactions with the cDC2 subclusters. A robust identification and characterization of these immune cell subsets will build towards our understanding of the interactions between these subpopulations triggered by inflammasome activation within the TME and the mechanisms behind ICB response. Citation Format: Yamil D. Mahmoud, Natalia Rego, Marcela Vilarino, Florencia Veigas, Maria R. Girotti, Juan M. Perez Saez, Gabriel A. Rabinovich, Marcelo Hill. Bioinformatic characterization of dendritic and T cell subpopulations in the tumor microenvironment across different cancer types by single-cell RNA-Seq analysis. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6548.

Previous therapy and the recurrence rate of basal cell carcinoma after Mohs surgery: a meta-analysis.

Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC) is indicated for patients at high risk of recurrence; other therapies, including standard surgical excision, cryotherapy, electrodesiccation and curettage, and radiotherapy, are used in low-risk BCC and in patients who cannot undergo surgery. However, in the case of recurrence following treatment with any of these methods, MMS is indicated. This study aimed to examine how preoperative treatment before MMS affects the recurrence rate after surgery. We conducted a meta-analysis to compare the recurrence rates of primary BCC and previously treated BCC in patients undergoing MMS, with a 5-year follow-up. The secondary outcomes were the recurrence rate after MMS based on previous radiation therapy status, mean time to recurrence, and number of cases undergoing more than one stage of MMS. The recurrence rate in the previously treated group was 2.44 times greater than that of the primary BCC group. In the previous treatment group, the patients who underwent previous radiation showed a 2.52-fold higher recurrence rate than those with no previous radiation therapy. However, there was no significant difference in the mean time to recurrence and the number of cases requiring MMS > 1 stage between the previously treated and non-treated groups. Patients with previously treated BCC, especially those treated using radiation, had a higher likelihood of recurrence.

The Quality of Life in Surgically Treated Head and Neck Basal Cell Carcinoma Patients: A Comprehensive Review.

In this review, we examine current literature analyzing the impact of surgical treatment on the QoL in patients with head and neck BCC. A comprehensive literature review was performed using the main databases. As many as six out of 322 articles were selected for the final analysis. The selected articles were published in the period between 2004 and 2021, most published within the last two years. All analyzed studies were prospective. Five out of six studies evaluated NMSC consisting of both BCC and SCC, and only one study selectively evaluated the impact of surgical treatment on QoL in patients with craniofacial BCC. Authors of the selected studies reported that QoL improves following the surgery; however, the effect on QoL varies. Patients' age, gender, marital status, education level, and employment status had a stronger correlation with QoL postoperatively, especially during the late follow-up period. Younger patients were more bothered by appearance-related issues. One study concluded that elderly patients did not experience a statistically significant improvement in QoL. This literature review demonstrated that there is no clear consensus on the use of a single disease-specific QoL measurement tool. Furthermore, there is a lack of studies assessing the impact of surgical treatment on QoL exclusively in patients with head and neck BCC and studies analyzing the multivariate correlation between QoL and tumor type, size, anatomic site, and treatment outcomes.

Perineal cutaneous basal cell carcinomas in patients with familial seronegative celiac disease: Report of three cases

Introduction: Celiac disease (CD) is an autoimmune enteropathy due to hypersensitivity to consumed gluten. Patients can present with gastrointestinal and systemic symptoms. CD often runs in families. Studies have reported multiple subtypes of CD including at least one seronegative variant. The cutaneous manifestations of CD remain to be delineated; some cases of seropositive CD are associated with dermatitis herpetiformis. We report. Cases: In this study, three patients with a longstanding history of personal and/or familial seronegative CD presented withwho developed basal cell carcinoma (BCC) of the perineum. We hope to inform clinical physicians about the possible relationship between CD and cutaneous malignancies. DiscussionResults: We report three adult patients with a diagnosed or suspected personal history of seronegative CD and a family history of CD, who presented with BCC of the perineum. Discussion: The mechanism by which CD causes BCC remains to be defined. Physicians should consider testing evaluating patients with skin cancer located in the perineum for CD.