الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Basel cell carcinoma (BCC) and squamous cell carcinoma (SCC) 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 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.
This work aimed to investigate the role of DDR1 in non-melanoma skin cancer through its immunohistochemical localization in skin biopsies of these diseases. Furthermore, we aimed to correlate its expression with different clinical and histopathologic parameters of the studied cases.
This retrospective and prospective case-control study was carried out on 104 patients with NMSC (77 patients with BCC, 27 patients with SCC) and 20 apparently healthy volunteers age and gender matched as a control. Prospective cases were selected from Outpatient Clinics of Dermatology and Plastic Surgery at Menoufia University Hospital. For the retrospective part of the study, tissue blocks were collected from archives of Pathology Department, Faculty of Medicine, Menoufia University, Egypt spanning the period between January 2018 and December 2019.The study was approved by the Ethical Committee of Menoufia University and all participants provided written informed consent before enrollment in the study.
Prospective cases were subjected to the full history taking, general and dermatological examinations while retrospective cases were collected from patients’ files.
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The age of BCC cases ranged between 15 to 90 years with 59.3 ± 18.22 as a mean and SD and 60 as a median. The cases were 35 males (45.5%) and 42 females (54.5%), with 35:42 as male to female ratio. No Cases presented with Extremities (0%), 66 cases presented with Head and Neck (85.7%) and 11 cases presented with Trunk affect (14.3%). The size of tumor ranged between 0.20-15 cm with 3.19 ± 2.47 as a mean ± SD and 3 as a median. The margins cannot be assessed in 29 cases (37.7%), they were free in 44 cases (57.1%) and involved in 4 cases (5.2%).
The age of SCC cases ranged between 6 to 77 years with 54.19 ± 20.27 as a mean ± SD and 54 as a median. The cases were 15 males (55.5%) and 12 females (44.4%), and male to female ratio was 5:3. Three Cases presented with Extremities (11.1%), 18 cases presented with Head and Neck (66.7%) and 6 cases presented with Trunk affect (22.2%). The size of tumor ranged between 0.5-15 with 3.67 ± 3.4 as a mean ± SD and 2.5 as a median The Margin can’t be assessed in 6 cases (22.2%), Free in 19 cases (70.4%) and involved in 2 cases (7.4%). Fourteen Cases (51.9%) were classified as a Grade II. The pathological stage in selected cases was identified as 11 stage I (40.7%), 4 cases as stage III (14.8%) and 12 cases as stage II (44.4%). Eleven cases were classified as stage I (40.7%), 12 cases as Stage II (44.4%) and 4 cases as Stage III (14.8%).
Control subjects were 8 (40%) males and 12 (60%) females with M:F ratio 1:3. Their ages ranged from 35 to 70 years with 49.95 ± 10.65 as a mean ± SD value.
There was no significant difference between NMSC and control group regarding to age, gender, and localization.
A significant stromal retraction was noted in BCC cases in comparison with SCC (P<0.001).
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However, there was no significant difference between SCC and BCC regarding the rest of clinicopathological parameters.
There was a significant difference between SCC & BCC regarding DDR1 tumour localization (P=0.027), whereas (25.9%) of SCC and (9.1%) of BCC showed membrano-cytoplasmic localization.
There was a significant difference between SCC & BCC cases regarding stromal DDR1 expression.
A significant high H-score of DDR1 was noted in BCC cases (P = 0.003).
Regarding H-score category of stromal DDR1 expression (58.11%) of BCC and (81.82%) of SCC belonged to low category (P = 0.042).
There was a significant difference between control group and NMSC cases regarding tumor localization (P<0.001), cytoplasmic localization was dominant in 86.5% cases of NMSC in comparison with control.
There were significant differences between the studied groups, regarding epithelial and stromal DDR1 H scores and H score groups category (P<0.001 for all). All cases of control group had belonged to high H score group, whereas majority of NMSC had belonged to high H score group in epithelium in contrary with stroma majority of NMSC was low H score (P < 0.001 for all).
There was significant difference between different groups regarding epithelial DDR1 localization as (90.9%) in BCC, (74.1%) in SCC and none of control showed cytoplasmic localizations (P<0.001). Whereas all control cases showed membrano cytoplasmic localization.
There was a significant difference between the studied groups, regarding epithelial DDR1 H scores (P <0.001).
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All cases of control group had significantly belonged to high H score group, whereas (62.3%) of BCC and (48.1%) of SCC showed high H score (P<0.001).
There was significant difference between different groups regarding DDR1 stromal status and positivity as (96.1%) in BCC, (81.5%) in SCC and (75%) of control (P<0.001).
There was a significant difference between the studied groups, regarding epithelial H score category (P <0.001). All cases of control group had belonged to high H score group, whereas (41.9%) of BCC and (18.18%) of SCC showed high H score (P<0.001).
There was no significant difference between high and low DDR1 tumor H-score categories in NMSC regarding clinicopathological parameters.
There was no significant difference between high and low DDR1 tumor -score categories in BCC regarding clinicopathological parameters.
There was a significant association between epithelial H score categories regarding to the localization of the tumor in the body. The high H score category has significantly higher percentage in head and neck (76.9%) (P=0.010).
There was no significant association between H score categories in tumor cells and the rest of clinical data of SCC.
There was a significant association between stromal H-score categories regarding to gender as (65.7%) of high H score were in female while (34.3%) in male (P = 0.042).
There was no significant association between H score categories in stroma and the clinical data of BCC.
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There was no significant association between H score categories in stroma and the clinical data of SCC.
There was significant positive correlation between NMSC tumor H score and NMSC stroma H score (r=0.667, P value < 0.001), BCC stroma H score has significant positive correlation with BCC tumor H score (r=0.653, P value < 0.001), SCC stroma H score has significant positive correlation with SCC tumor H score (r=0.647, P value < 0.001).