Abstract：
(1) Background: Keratinocyte cancer (KC) is associated with exposure to ultraviolet (UV) radiation. However, data are controversial as to whether chronic UV exposure or high intermittent UV exposure are key drivers of carcinogenesis in cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC). Prolonged sun exposure of the skin causes photo-aging, which is associated with actinic elastosis, a condition characterized by the degeneration of elastin in the upper dermis, which is assessable via conventional histology. In this study, we aimed to compare the degree of actinic elastosis in different types of KC with regard to various patient characteristics. (2) Methods: We defined a semiquantitative score for the degree of actinic elastosis ranging from 0 = none to 3 = total loss of elastic fibers (basophilic degeneration). The extent was measured histometrically by two independent dermatohistopathologists in the immediate vicinity of 353 KC. The scores were merged and matched with tumor types (cSCC and BCC with subtypes), and clinical variables such as body site, sex and age. (3) Results: As expected, the degree of actinic elastosis correlated with age. However, it was significantly higher in cSCC compared to BCC irrespective of age, sex, body site and tumor subtypes. (4): Conclusions: Lifetime sun exposure may be estimated via routine histology using this scoring technique for actinic elastosis as a surrogate marker. cSCCs are more strongly associated with chronic UV exposure than BCCs, even in sun-exposed localizations such as the face.
摘要：
（1）背景：角质形成细胞癌（KC）与紫外线（UV）辐射有关。然而,在皮肤鳞状细胞癌(cSCC)和基底细胞癌(BCC)中,慢性紫外线暴露或高间歇性紫外线暴露是致癌的关键驱动因素,数据存在争议.长时间的阳光照射会导致皮肤老化，这与光化性弹性沉着有关，一种以真皮上部弹性蛋白变性为特征的疾病，这是可以通过常规组织学评估的。在这项研究中,我们的目的是根据不同的患者特征,比较不同类型KC患者的光化性弹性增生程度.（2）方法：我们定义了光化性弹性变性程度的半定量评分，范围从0=无到3=弹性纤维的总损失（嗜碱性变性）。由两名独立的皮肤组织病理学家在353KC附近进行组织学测量。将评分合并并与肿瘤类型（具有亚型的cSCC和BCC）匹配，和临床变量，如身体部位，性别和年龄。（3）结果：如预期，光化性弹性增生的程度与年龄相关。然而,与BCC相比，无论年龄大小，在cSCC中明显更高，性别,身体部位和肿瘤亚型。（4）：结论：可以通过常规组织学评估，使用这种光化性弹性变性的评分技术作为替代标记来估计一生的阳光暴露。cSCC比BCC更强烈地与慢性紫外线暴露相关，即使在阳光照射的地方，如面部。
