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Thickness of Actinic Keratosis Does Not Predict Dysplasia Severity or P53 Expression

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ABSTRACT

The severity of dysplasia and expression of p53 in actinic keratosis (AK) is of importance for the transformation to squamous cell carcinoma. It is assumed that it is most important to treat thick AKs as they are believed to be more dysplastic than thin AKs. However, a relation between AK thickness and dysplasia or the expression of p53 has never been demonstrated. The aim of this study was to investigate this possible relation. Sixty-six AKs were included for clinical and histological examination. Prior to performing a punch biopsy, the clinical thickness of each AK was measured objectively using two scale bars with a thickness of 0.5 mm and 1 mm. Subsequently, the thickness of the epidermis, the severity of dysplasia and the expression of p53 were assessed histologically. We found a strong and significant positive correlation between measured clinical thickness of the AKs and the histological thickness of epidermis (p < 0.0001). However, the clinical thickness did not correlate with either the severity of dysplasia (p = 0.7) or the expression of p53 (p = 0.5). In conclusion, thin AKs show the same severity of dysplasia and expression of p53 as thicker AK lesions. Consequently, clinical thickness cannot predict aggressiveness.

No MeSH data available.


Related in: MedlinePlus

The stratum corneum hydration and corresponding histological thicknesses.Scatter plot of the stratum corneum hydration and corresponding histological thicknesses of total epidermis. The stratum corneum hydration decreased significantly with increasing histological thickness of total epidermis (r = 0.54, p < 0.0001).
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f1: The stratum corneum hydration and corresponding histological thicknesses.Scatter plot of the stratum corneum hydration and corresponding histological thicknesses of total epidermis. The stratum corneum hydration decreased significantly with increasing histological thickness of total epidermis (r = 0.54, p < 0.0001).

Mentions: The clinical thickness was differentiated in three categories; (i) less than 0.5 mm;(ii) between 0.5 and 1 mm; and (iii) more than 1 mm. The histological thickness of the stratum corneum, cellular epidermis and total epidermis of the 66 AKs are shown in Table 1. The histological thickness of the stratum corneum was significantly different in the three categories of clinical thickness (in all comparisons, p < 0.0002), and stratum corneum thickness increased significantly with increasing clinical thickness of AK (r = 0.68, p < 0.0001) as did the histological thickness of the cellular epidermis (r = 0.41, p = 0.001) and total epidermis (r = 0.72, p < 0.0001). The histological thickness of the stratum corneum increased significantly with increasing thickness of the cellular epidermis (r = 0.43, p = 0.003). The stratum corneum hydration decreased significantly with increasing histological thickness of the stratum corneum (r = 0.50, p < 0.0001), cellular epidermis (r = 0.33, p = 0.007) and total epidermis (r = 0.54, p < 0.0001) (Fig. 1). The clinical thickness was not patient dependent (p = 1.0).


Thickness of Actinic Keratosis Does Not Predict Dysplasia Severity or P53 Expression
The stratum corneum hydration and corresponding histological thicknesses.Scatter plot of the stratum corneum hydration and corresponding histological thicknesses of total epidermis. The stratum corneum hydration decreased significantly with increasing histological thickness of total epidermis (r = 0.54, p < 0.0001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037398&req=5

f1: The stratum corneum hydration and corresponding histological thicknesses.Scatter plot of the stratum corneum hydration and corresponding histological thicknesses of total epidermis. The stratum corneum hydration decreased significantly with increasing histological thickness of total epidermis (r = 0.54, p < 0.0001).
Mentions: The clinical thickness was differentiated in three categories; (i) less than 0.5 mm;(ii) between 0.5 and 1 mm; and (iii) more than 1 mm. The histological thickness of the stratum corneum, cellular epidermis and total epidermis of the 66 AKs are shown in Table 1. The histological thickness of the stratum corneum was significantly different in the three categories of clinical thickness (in all comparisons, p < 0.0002), and stratum corneum thickness increased significantly with increasing clinical thickness of AK (r = 0.68, p < 0.0001) as did the histological thickness of the cellular epidermis (r = 0.41, p = 0.001) and total epidermis (r = 0.72, p < 0.0001). The histological thickness of the stratum corneum increased significantly with increasing thickness of the cellular epidermis (r = 0.43, p = 0.003). The stratum corneum hydration decreased significantly with increasing histological thickness of the stratum corneum (r = 0.50, p < 0.0001), cellular epidermis (r = 0.33, p = 0.007) and total epidermis (r = 0.54, p < 0.0001) (Fig. 1). The clinical thickness was not patient dependent (p = 1.0).

View Article: PubMed Central - PubMed

ABSTRACT

The severity of dysplasia and expression of p53 in actinic keratosis (AK) is of importance for the transformation to squamous cell carcinoma. It is assumed that it is most important to treat thick AKs as they are believed to be more dysplastic than thin AKs. However, a relation between AK thickness and dysplasia or the expression of p53 has never been demonstrated. The aim of this study was to investigate this possible relation. Sixty-six AKs were included for clinical and histological examination. Prior to performing a punch biopsy, the clinical thickness of each AK was measured objectively using two scale bars with a thickness of 0.5&thinsp;mm and 1&thinsp;mm. Subsequently, the thickness of the epidermis, the severity of dysplasia and the expression of p53 were assessed histologically. We found a strong and significant positive correlation between measured clinical thickness of the AKs and the histological thickness of epidermis (p&thinsp;&lt;&thinsp;0.0001). However, the clinical thickness did not correlate with either the severity of dysplasia (p&thinsp;=&thinsp;0.7) or the expression of p53 (p&thinsp;=&thinsp;0.5). In conclusion, thin AKs show the same severity of dysplasia and expression of p53 as thicker AK lesions. Consequently, clinical thickness cannot predict aggressiveness.

No MeSH data available.


Related in: MedlinePlus