DNA ploidy and cyclin D1 expression in basal cell carcinoma of the head and neck

Basal cell carcinomas (BCCs) may be subdivided into primary, with a favorab le biologic course (BCC1) and recurrent and/or metastatic (BCC2), No clear association between primary tumor location, histologic subtype, or other cl inicopathologic variables and predisposition for BCC2 has been found. Histo pathologic criteria are limited for prognostication. To identify prognostic factors useful for planning therapy, we studied cycl in DJ immunohistochemical expression, DNA ploidy, and epiluminescence light microscopic (ELM) patterns in 60 cases of BCC (30 BCC1 and 30 BCC2) in the head and neck region, half of which were hyperpigmented. Cyclin DI was abs ent in 27 cases, expressed at low level in 4 cases, and overexpressed in 30 cases. Seven BCCs were euploid, 28 exhibited a mired cellular population, and 25 were aneuploid. Among aneuploid tumors, hypodiploidy was found in 12 . Among the 30 pigmented carcinomas, only 15 showed a typical ELM pattern. No association between pigmentation and more aggressive biologic behavior o f BCC was found. These results and follow-up data seem to indicate that an unfavorable outco me can be predicted bl hyperexpression of cyclin DI, aneuploidy, and an aty pical ELM pattern for pigmented cases. A definite hypodiploid peak was asso ciated with worse prognosis. The analysis of cyclin DI expression and DNA p loidy may help identify, BCC with an aggressive phenotype and a poor clinic al outcome.