angiogenesis assessment in basal cell carcinoma

basal cell carcinoma (bcc) is currently the most common cutaneous cancer found in humans. although it generally shows a relatively benign course (bccl), some cases show aggressive behavior (bcc2). until recently, traditional histologic diagnostic criteria have failed to discriminate unequivocally between bcc 1 and bcc2. in this study we selected 50 cases of bcc and categorized them into two groups (bccl and bcc2) on the basis of histologic criteria and then examined the rate of angiogenesis to establish if it correlates with their histological features and/or clinical behavior. the vessels were highlighted by immunohistochemical staining for factor viii-related antigen in formalin fixed paraffin embedded tissues. all 25 cases of bcc2, whose clinical behavior was aggressive had microvessel counts significantly higher than that of the bcc i group with mean values of 50.24 and 20.9 for bcc2 and bccl respectively. but there were eight cases of morphological bcci who had aggressive clinical behavior and interestingly had microvessel counts higher than the other cases of bcc 1. the findings of the present study seem to establish a correlation between tumor angiogenesis and clinicobiologicai parameters of aggressiveness. from this point of view the assay of microvessel density might be helpful in selecting patients with bccs at high risk for recurrence or metastasis, who could benefit from additional therapies and closer followup.