Evaluation of the Basement Membrane in Morpheaform Basal Cell Carcinoma

Overview

Introduction:
Infiltrative type of basal cell carcinoma, known as ”morpheaform basalioma” is an invasively growing type of malignant epithelial tumor. Tumor behavior is influenced also by the tumor basement membrane state and by relation of tumor parenchyma to tumor stroma. In routine practice the histopathologists follow an empirical judgement of the basement membrane using various visualization imunohistochemethods. In our paper we tried to statistically evaluate the validity of use of the most frequent visualization methods of basement membrane assessment in the histopathological practice.

Material and methods:
10 morpheaform basaliomas samples of the bioptic register of The Institute of Pathological Anatomy of JLF UK in Martin were processed by Gomori impregnation method, PAS method and immunohistochemical detection of laminin. The basement membrane integrity was evaluated semiquantitatively measuring each 5 visual fields in 400 fold magnification. The results were processed by standard statistical methods used in data of small number of statistical untis.

Results:
The median value 20.5 was the same using PAS method and laminin detection, in comparison to the 14.5 value acquired if calculating the basement membrane status using Gomori method. The extent of minimal to maximal values was the largest from 12 to 24 using detection of laminin, similarly, but with extent from 11 to 22 using Gomori method. PAS method had the smallest extent from 18 to 24 but in higher values.

Conclusion:
Efficacy of suitable diagnostic methods plays one of the most important roles in the process of diagnosis. The study warns that evaluation of the basement membrane integrity in morpheaform basalioma by a PAS method is only approximative. We consider the Gomori method the most sensitive method in assessment of the defects of the basement membrane integrity. Immunohistochemical detection of laminin allows evaluating a qualitative precursor state with identification of its local production loss in some tumor cells in the morpheaform basalioma.

Key words:
morpheaform carcinoma – basement membrane – laminin