الفهرس 
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Abstract
Basal and squamous cell carcinoma are the common malignant neoplasms of the skin. BCC is characterized by local invasion and contiguous spread. SCC is a biologically aggressive tumor and usually metastasizes. Following local invasion and tissue destruction, SCC commonly metastasizes to lymph nodes. The cause of vitiligo is still unknown but there are many theories concerning the cause such as the autoimmune, autocytotoxic and neural hypothesis, oxidative stress, genetic factors, and melanocytorrhagy.
The goal of current study was to investigate immunohistochemical expression of LC3 and Beclin 1, the most common indicator of autophagy, and their effect on pathogenesis of NMSC.
This retrospective and prospective case-control study was conducted on 102 patients with NMSC these included 77 cases with BCC, 25 cases with SCC and 20 age, gender and localization matched healthy subjects as a control group. Cases of BCC and SCC were selected from Dermatology Outpatient Clinic, Menoufiya University Hospital during the period from January 2016 to December 2017. For the retrospective part of the study, tissue blocks of archived cases in Pathology Department were used.
All studied individuals were subjected to history taking as personal history: name, gender, age, residence, special habit, present history: onset, duration and coarse, family history, clinical examination: site of NMSC. Immunohistochemical expression of LC3 and Beclin 1 and there localization in relation to the clinical and histopathological parameters were investigated. Normal skin samples were obtained from subjects attending Plastic Surgery Department.
A written consent form approved by the Committee of Human Rights in Research in Menoufia University was obtained from every subject before the study initiation.
All patients were subjected to detailed history taking and dermatological examination. Biopsies were taken from all cases and
control subjects. Routine histopathological examination with H&E stain was done as well as immunohistochemical staining to evaluate the expression of LC3 and Beclin 1 antigens by using Rabbit polyclonal antibodies.
Autophagy, literally meaning “self-eating,” is an intracellular catabolic process of delivering cytosol and/or its specific content to the lysosomes for degradation.
Beclin 1, also named autophagy gene 6 (Atg6), is the first identified mammalian Atg protein and an essential autophagy inducer.
Microtuble-associated protein light chain 3 (LC3), a mammalian homolog of yeast autophagy gene 8 (ATG8), has been used as a specific marker to monitor autophagy.
BCC cases were 28 (36.3%) males and 49 (63.6%) females. Their ages ranged from 11 to 90 years with 59.06±19.04 as a mean± SD value. Lesion size ranged from 0.5 to12 cm with 3.2±2.4 as a mean ± SD value. Regardenig the site, 65 cases were on the head and neck (84.4%). Regarding the clinical subtypes of BCC, 30 cases (39%)
Summary
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were presented with ulcer and 28 case (36.4%) was presented with nodular lesion. Histopathologically 40 cases (51.9%) had adenoid BCC,37 cases (48.1%) had solid BCC. BCC 44 cases (57.1%) had free surgical margin and4 cases (5.2%) had involved surgical margin.
SCC were 20 (80%) males and 5(20%) females. Their ages ranged from 6 to 77 years with 57.8±16.16 as mean± SD value. Lesion size ranged from 0.5 to15 cm with 3.8±2.5 as mean ± SD value. Regardenig the site, 9 cases (36 %) were on the Head and neck , 2 cases (8 %) were on the extremeties, and 14 cases were on the Trunk . Regarding the clinical types of SCC, 9 cases (36%) were presented with Noduloulcerative and 16 cases (64%) were presented with nodular lesions. Histopathologically, 8 cases (32%) were Adenoid , 17 cases (68%) were Solid. Regarding surgical margin,19 cases (76%) had free surgical margin and 1 case (4%) had involved surgical margin.
Control subjects were 18(90%) males and 2 (10%) females. Their ages ranged from 18 to 70 years with 54.1±16.26 as a mean ± SD value.
There was a significant difference between NMSC and control regarding epithelial and stromal localization of LC3 (P=<0.001). Epithelial and stromal nucleocytoplasmic localizations were dominant in all cases of NMSC in comparison with control.
There was a significant difference between NMSC and control regarding epithelial and stromal LC3 H scores and H groups (P>0.001). All cases of control group had belonged to low H score group, whereas majority of NMSC had belonged to high H score group.
Regarding Beclin 1, there was a significant difference between NMSC and control regarding epithelial and stromal localization of Beclin 1 (P=<0.001). Epithelial and stromal nucleocytoplasmic localizations were dominant in all cases of NMSC in comparison with control.
There was a significant difference between NMSC and control regarding epithelial and stromal Beclin 1 H scores and H groups (P>0.001). All cases of control group had belonged to low H score group, whereas majority of NMSC had belonged to high H score group.
There was statistical significant difference between two groups regarding epithelial and stromal sever intensity of Beclin1 (P=<0.001).
Comparing the 3 studied groups regarding LC3 expression, both epithelial and stromal LC3 were expressed in all participants with a significant difference regarding cellular localization. All patients showed a nucleocytoplasmic localization of LC3 with control showed both cytoplasmic and nucleocytoplasmic expression (p <0.001). All cases of control group had belonged to low H score group, whereas majority of BCC and SCC had belonged to high H score group.
Comparing the 3 studied groups regarding Beclin 1 expression, both epithelial and stromal Beclin 1 were expressed in all participants with a significant difference regarding cellular localization. All patients showed a nucleocytoplasmic localization of Beclin 1 with control showed nucleocytoplasmic expression (p <0.001). All cases of control group had belonged to low H score group, whereas majority of BCC and SCC had belonged to high H score group.