Association of the expression of Bcl-2 and Ki-67 prognostic markers and apoptotic index with biological behaviour in aggressive and non-aggressive non-melanoma eyelid skin cancer

Bcl-2和Ki-67预后标志物表达及细胞凋亡指数与侵袭性和非侵袭性非黑色素瘤眼睑皮肤癌生物学行为的相关性

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Abstract

INTRODUCTION: Prognostic biomarkers facilitate the identification of high-risk tumours. AIM: To evaluate the association of Bcl-2 protein and Ki-67 antigen expression and the apoptotic index with biological behaviour of non-melanoma eyelid tumours. MATERIAL AND METHODS: Combined analysis of retrospective and prospective study of data from two centres over a period from 2008 to 2023 on histologically confirmed malignant non-melanoma eyelid tumours without any age limitation. Selected prognostic markers related to the aggressive or non-aggressive tumour types were evaluated. RESULTS: The study cohort included 68 patients with 70 non-melanoma eyelid tumours (n = 70). The basal cell carcinoma was the most frequently present type (97.1%). The median age was 68 years. A tumour size > 5 mm correlates to the aggressive type (p = 0.047). Resection margins < 2 mm were in 33.9%, without any connection to the recurrence rate (p = 0.076). The average value of Bcl-2 expression in non-aggressive types was 82.65% (p < 0.001). The value of Ki-67 expression in patients with non-aggressive tumours was 35.49% (p = 0.068). Non-aggressive tumours most frequently exhibited the apoptotic index of Grade I (p = 0.535). No Grade III case was observed in the aggressive types. In 2 cases, the orbital exenteration was carried out (0.03%). In 1 case biological therapy was administered. HDR brachytherapy was applied in 6 cases. A recurrence of the disease was observed in 4 (0.06%) cases. CONCLUSIONS: New information on cancer biomarkers in non-melanoma eyelid skin carcinoma contributes to choosing a correct therapy with achieving good aesthetic results and a good survival rate.

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