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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Basal cell carcinoma &#40;BCC&#41; is a common malignant tumor and its incidence has risen in recent decades&#46; Research has shown the relationship between ultraviolet &#40;UV&#41; radiation&#44; the skin immune system&#44; and BCC&#46; The role of Langerhans cells &#40;LC&#41; in the immune response to tumors has prompted research into LC density and morphology in response to UV radiation and BCC&#46; However&#44; the data are inconsistent due to differences in research methodology&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To study the density and morphology of LCs in the peritumoral epidermis of BCC using immunohistochemistry and image processing software and compare the results with those from the epidermis overlying the tumor&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Twelve samples from patients with BCC were prepared with a CD1a stain&#46; Areas of epidermis overlying and adjacent to the tumor were defined using light microscopy and the Image J image processing software&#46; The LCs in each area were counted and the cell densities were calculated and compared&#46; Morphological features of LCs were also evaluated in each epidermal area&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The results showed a lower density of LCs in the epidermis overlying the tumor than in the peritumoral epidermis &#40;P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; There were also differences in the size&#44; shape&#44; and dendritic pattern of the LCs between the epidermal areas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The lower density and fewer morphological changes of LCs in the epidermis overlying BCC may give rise to alterations in the immune response to BCC&#46; Digital image analysis is a reliable method for the morphometric evaluation of LCs&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">El carcinoma basocelular &#40;CBC&#41; es un tumor maligno frecuente y su incidencia ha aumentado en las &#250;ltimas d&#233;cadas&#46; Investigaciones han demostrado la relaci&#243;n entre radiaci&#243;n ultravioleta &#40;RUV&#41;&#44; sistema inmune cut&#225;neo y CBC&#46; La funci&#243;n de las c&#233;lulas de Langerhans &#40;CL&#41; en la respuesta inmuneantitumoral ha motivado la investigaci&#243;n de su densidad y morfolog&#237;a frente a la RUV y al CBC&#46; Sin embargo&#44; los resultados publicados presentan discordancias debido a diferencias en la metodolog&#237;a cient&#237;fica&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiar la densidad y morfolog&#237;a de las CL en la epidermis peritumoral comparada con la epidermis supratumoral mediante inmunohistoqu&#237;mica y un programa computacional de im&#225;genes digitales&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Doce casos de CBC fueron te&#241;idos con CD1a&#46; Se utiliz&#243; microscopia &#243;ptica y el programa computacional Image J para calcular las &#225;reas epid&#233;rmicas sobre el tumor y adyacente a &#233;l&#46; Se contabilizaron el n&#250;mero de CL de cada &#225;rea y se determinaron y compararon las densidades celulares&#46; Finalmente&#44; se analiz&#243; la morfolog&#237;a de las CL en ambas &#225;reas epid&#233;rmicas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados mostraron una menor densidad celular en la epidermis supratumoral respecto a la peritumoral &#40;p &#60; 0&#44;05&#41;&#46; Las CL entre ambas &#225;reas presentaron diferencias en el tama&#241;o&#44; forma celular y patr&#243;n dendr&#237;tico&#46;</p> <span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">La menor densidad y alteraciones estructurales de las CL supratumorales podr&#237;an dar lugar a variaciones de la respuesta inmune en el CBC&#46; El uso de tecnolog&#237;a de an&#225;lisis de im&#225;genes digitales ser&#237;a un m&#233;todo fiable en el estudio morfom&#233;trico de las CL&#46;</p>"
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                      "titulo" => "What causes basal cell carcinoma to be the commonest cancer&#63;"
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                        0 => array:2 [
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                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Gilbody"
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                            2 => "A&#46; Green"
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                    ]
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                    0 => array:1 [
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                        "tituloSerie" => "Aust J Public Health"
                        "fecha" => "1994"
                        "volumen" => "18"
                        "paginaInicial" => "218"
                        "paginaFinal" => "221"
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                          "autores" => array:2 [
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                    0 => array:1 [
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                        "tituloSerie" => "J Am Acad Dermatol"
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                        "paginaInicial" => "774"
                        "paginaFinal" => "778"
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                            2 => "C&#46; Mihalcioiu"
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                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11559211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in non-melanocytic skin cancer treated in Australia&#58; the second national survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Marks"
                            1 => "M&#46; Staples"
                            2 => "G&#46;G&#46; Giles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "1993"
                        "volumen" => "53"
                        "paginaInicial" => "585"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8436431"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caracter&#237;sticas sociodemogr&#225;ficas del c&#225;ncer cut&#225;neo en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; P&#233;rez-Su&#225;rez"
                            1 => "A&#46; Guerra-Tapia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2008"
                        "volumen" => "99"
                        "paginaInicial" => "119"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18346433"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative analysis of T6-positive Langerhans cells in human skin cancers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Meissner"
                            1 => "M&#46; Haftek"
                            2 => "M&#46; Arlot"
                            3 => "G&#46; Mauduit"
                            4 => "J&#46; Thivolet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Virchows Arch A Pathol Anat Histopathol"
                        "fecha" => "1986"
                        "volumen" => "410"
                        "paginaInicial" => "57"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3097953"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differentiation of Langerhans cells from interdigitating cells using CD1a and S-100 protein antibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Shinzato"
                            1 => "M&#46; Shamoto"
                            2 => "S&#46; Hosokawa"
                            3 => "C&#46; Kaneko"
                            4 => "A&#46; Osada"
                            5 => "M&#46; Shimizu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biotech Histochem"
                        "fecha" => "1995"
                        "volumen" => "70"
                        "paginaInicial" => "114"
                        "paginaFinal" => "118"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7548432"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alterations in human epidermal Langerhans cells by ultraviolet radiation&#58; quantitative and morphological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Seit&#233;"
                            1 => "H&#46; Zucchi"
                            2 => "D&#46; Moyal"
                            3 => "S&#46; Tison"
                            4 => "D&#46; Compan"
                            5 => "F&#46; Christiaens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2003"
                        "volumen" => "148"
                        "paginaInicial" => "291"
                        "paginaFinal" => "299"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12588382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative and 3-dimensional analysis of Langerhans cells in basal cell carcinoma&#46; A comparative study using light microscopy and confocal laser scanning microscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Bergfelt"
                            1 => "A&#46; Emilson"
                            2 => "M&#46; Lindberg"
                            3 => "A&#46; Scheynius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1994"
                        "volumen" => "130"
                        "paginaInicial" => "273"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7511926"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhans cells utilize CD1a and langerin to efficiently present nonpeptide antigens to T cells"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;E&#46; Hunger"
                            1 => "P&#46;A&#46; Sieling"
                            2 => "M&#46;T&#46; Ochoa"
                            3 => "M&#46; Sugaya"
                            4 => "A&#46;E&#46; Burdick"
                            5 => "T&#46;H&#46; Rea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1172/JCI19655"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Invest"
                        "fecha" => "2004"
                        "volumen" => "113"
                        "paginaInicial" => "701"
                        "paginaFinal" => "708"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14991068"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Density and morphology of Langerhans cells in basal cell carcinomas of the face and trunk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Bergfelt"
                            1 => "O&#46; Larko"
                            2 => "M&#46; Lindberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1992"
                        "volumen" => "127"
                        "paginaInicial" => "575"
                        "paginaFinal" => "579"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1476916"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhans&#8217; cells and T cells in human skin tumours&#58; an immunohistological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;C&#46; Gatter"
                            1 => "H&#46;B&#46; Morris"
                            2 => "B&#46; Roach"
                            3 => "P&#46; Mortimer"
                            4 => "K&#46;A&#46; Fleming"
                            5 => "D&#46;Y&#46; Mason"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Histopathology"
                        "fecha" => "1984"
                        "volumen" => "8"
                        "paginaInicial" => "229"
                        "paginaFinal" => "244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6233213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhans&#8217; cells in skin tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;U&#46; Schreiner"
                            1 => "G&#46; Lischka"
                            2 => "G&#46; Schaumburg-Lever"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1995"
                        "volumen" => "131"
                        "paginaInicial" => "187"
                        "paginaFinal" => "190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7857116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perturbation of epidermal Langerhans cells in basal cell carcinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Azizi"
                            1 => "C&#46; Bucana"
                            2 => "L&#46; Goldberg"
                            3 => "M&#46;L&#46; Kripke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dermatopathol"
                        "fecha" => "1987"
                        "volumen" => "9"
                        "paginaInicial" => "465"
                        "paginaFinal" => "473"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2965525"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhans cells in cutaneous tumours&#58; immunohistochemistry study using a computer image analysis system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; De Melo Jr"
                            1 => "J&#46;L&#46; Araujo Filho"
                            2 => "V&#46;J&#46; Patu"
                            3 => "M&#46;C&#46; Machado"
                            4 => "L&#46;A&#46; Mello"
                            5 => "L&#46;B&#46; Carvalho Jr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10735-006-9056-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Mol Histol"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "321"
                        "paginaFinal" => "325"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17080294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative assessment of Langerhans cells in actinic keratosis&#44; Bowen&#39;s disease&#44; keratoacanthoma&#44; squamous cell carcinoma and basal cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;P&#46; McArdle"
                            1 => "B&#46;A&#46; Knight"
                            2 => "G&#46;M&#46; Halliday"
                            3 => "H&#46;K&#46; Muller"
                            4 => "G&#46; Rowden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pathology"
                        "fecha" => "1986"
                        "volumen" => "18"
                        "paginaInicial" => "212"
                        "paginaFinal" => "216"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3763243"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhan&#39;s cells in skin tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46; Valcuende-Cavero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1995"
                        "volumen" => "131"
                        "paginaInicial" => "1463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7492144"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Basal cell carcinoma-new aspects of diagnosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;M&#46; Wennberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Derm Venereol Suppl &#40;Stockh&#41;"
                        "fecha" => "2000"
                        "volumen" => "209"
                        "paginaInicial" => "5"
                        "paginaFinal" => "25"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Langerhans cells in squamous cell carcinoma vs&#46; pseudoepitheliomatous hyperplasia of the skin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Galan"
                            1 => "C&#46;J&#46; Ko"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1600-0560.2007.00741.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cutan Pathol"
                        "fecha" => "2007"
                        "volumen" => "34"
                        "paginaInicial" => "950"
                        "paginaFinal" => "952"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18001421"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative and threedimensional analysis of human Langerhans cells in epidermal sheets and vertical skin sections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Emilson"
                            1 => "A&#46; Scheynius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Histochem Cytochem"
                        "fecha" => "1995"
                        "volumen" => "43"
                        "paginaInicial" => "993"
                        "paginaFinal" => "998"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7560889"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differential effects of UVA1 and UVB radiation on Langerhans cell migration in mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;S&#46; Duthie"
                            1 => "I&#46; Kimber"
                            2 => "R&#46;J&#46; Dearman"
                            3 => "M&#46; Norval"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Photochem Photobiol B"
                        "fecha" => "2000"
                        "volumen" => "57"
                        "paginaInicial" => "123"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11154078"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of ultraviolet radiation on murine epidermal Langerhans cells&#58; doses of ultraviolet radiation that modulate ICAM-1 &#40;CD54&#41; expression and inhibit Langerhans cell function cause delayed cytotoxicity in vitro"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Tang"
                            1 => "M&#46;C&#46; Udey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Invest Dermatol"
                        "fecha" => "1992"
                        "volumen" => "99"
                        "paginaInicial" => "83"
                        "paginaFinal" => "89"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1351507"
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Vol. 100. Issue 8.
Pages 700-705 (October 2009)
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Vol. 100. Issue 8.
Pages 700-705 (October 2009)
Original article
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CD1a+ Langerhans Cells in the Peritumoral Epidermis of Basal Cell Carcinoma
Células de Langerhans CD1a+ en la Epidermis Peritumoral del Carcinoma Basocelular
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F. Mardonesa,
Corresponding author
fmardonesv@yahoo.com

Correspondence: Felipe Mardones Valdivieso, Departamento de Dermatología, Hospital Clínico, Universidad de Chile, Santos Dumont, 999, Santiago, Chile.
, V. Zemelmana, I. Sazunicb, C. Moralesb, K. Palmac, M. Vargasd
a Departamento de Dermatología, Hospital Clínico, Universidad de Chile, Santiago, Chile
b Instituto de Anatomía Patológica, Hospital Clínico, Universidad de Chile, Santiago, Chile
c Unidad de Análisis Celular Integral, Centro de Equipamiento y Servicio de Apoyo Tecnológico (CESAT), Facultad de Medicina, Universidad de Chile, Santiago, Chile
d Laboratorio Central de Inmunohistoquímica, S.A., Santiago, Chile
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Abstract
Background

Basal cell carcinoma (BCC) is a common malignant tumor and its incidence has risen in recent decades. Research has shown the relationship between ultraviolet (UV) radiation, the skin immune system, and BCC. The role of Langerhans cells (LC) in the immune response to tumors has prompted research into LC density and morphology in response to UV radiation and BCC. However, the data are inconsistent due to differences in research methodology.

Objective

To study the density and morphology of LCs in the peritumoral epidermis of BCC using immunohistochemistry and image processing software and compare the results with those from the epidermis overlying the tumor.

Material and methods

Twelve samples from patients with BCC were prepared with a CD1a stain. Areas of epidermis overlying and adjacent to the tumor were defined using light microscopy and the Image J image processing software. The LCs in each area were counted and the cell densities were calculated and compared. Morphological features of LCs were also evaluated in each epidermal area.

Results

The results showed a lower density of LCs in the epidermis overlying the tumor than in the peritumoral epidermis (P<0.05). There were also differences in the size, shape, and dendritic pattern of the LCs between the epidermal areas.

Conclusions

The lower density and fewer morphological changes of LCs in the epidermis overlying BCC may give rise to alterations in the immune response to BCC. Digital image analysis is a reliable method for the morphometric evaluation of LCs.

Key words:
basal cell carcinoma
Langerhans cells
density
Resumen
Introducción

El carcinoma basocelular (CBC) es un tumor maligno frecuente y su incidencia ha aumentado en las últimas décadas. Investigaciones han demostrado la relación entre radiación ultravioleta (RUV), sistema inmune cutáneo y CBC. La función de las células de Langerhans (CL) en la respuesta inmuneantitumoral ha motivado la investigación de su densidad y morfología frente a la RUV y al CBC. Sin embargo, los resultados publicados presentan discordancias debido a diferencias en la metodología científica.

Objetivo

Estudiar la densidad y morfología de las CL en la epidermis peritumoral comparada con la epidermis supratumoral mediante inmunohistoquímica y un programa computacional de imágenes digitales.

Material y métodos

Doce casos de CBC fueron teñidos con CD1a. Se utilizó microscopia óptica y el programa computacional Image J para calcular las áreas epidérmicas sobre el tumor y adyacente a él. Se contabilizaron el número de CL de cada área y se determinaron y compararon las densidades celulares. Finalmente, se analizó la morfología de las CL en ambas áreas epidérmicas.

Resultados

Los resultados mostraron una menor densidad celular en la epidermis supratumoral respecto a la peritumoral (p < 0,05). Las CL entre ambas áreas presentaron diferencias en el tamaño, forma celular y patrón dendrítico.

Discusión

La menor densidad y alteraciones estructurales de las CL supratumorales podrían dar lugar a variaciones de la respuesta inmune en el CBC. El uso de tecnología de análisis de imágenes digitales sería un método fiable en el estudio morfométrico de las CL.

Palabras clave:
carcinoma basocelular
células de Langerhans
densidad
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References
[1.]
J.S. Gilbody, J. Aitken, A. Green.
What causes basal cell carcinoma to be the commonest cancer?.
Aust J Public Health, 18 (1994), pp. 218-221
[2.]
D.L. Miller, M.A. Weinstock.
Nonmelanoma skin cancer in the United States: incidence.
J Am Acad Dermatol, 30 (1994), pp. 774-778
[3.]
A.A. Demers, Z. Nugent, C. Mihalcioiu, M.C. Wiseman, E.V. Kliewer.
Trends of nonmelanoma skin cancer from 1960 through 2000 in a Canadian population.
J Am Acad Dermatol, 53 (2005), pp. 320-328
[4.]
R. Corona, E. Dogliotti, M. D’Errico, F. Sera, I. Lavarone, G. Baliva, et al.
Risk factors for basal cell carcinoma in a Mediterranean population: role of recreational sun exposure early in life.
Arch Dermatol, 137 (2001), pp. 1162-1168
[5.]
R. Marks, M. Staples, G.G. Giles.
Trends in non-melanocytic skin cancer treated in Australia: the second national survey.
Int J Cancer, 53 (1993), pp. 585-590
[6.]
B. Pérez-Suárez, A. Guerra-Tapia.
Características sociodemográficas del cáncer cutáneo en España.
Actas Dermosifiliogr, 99 (2008), pp. 119-126
[7.]
K. Meissner, M. Haftek, M. Arlot, G. Mauduit, J. Thivolet.
Quantitative analysis of T6-positive Langerhans cells in human skin cancers.
Virchows Arch A Pathol Anat Histopathol, 410 (1986), pp. 57-63
[8.]
M. Shinzato, M. Shamoto, S. Hosokawa, C. Kaneko, A. Osada, M. Shimizu, et al.
Differentiation of Langerhans cells from interdigitating cells using CD1a and S-100 protein antibodies.
Biotech Histochem, 70 (1995), pp. 114-118
[9.]
S. Seité, H. Zucchi, D. Moyal, S. Tison, D. Compan, F. Christiaens, et al.
Alterations in human epidermal Langerhans cells by ultraviolet radiation: quantitative and morphological study.
Br J Dermatol, 148 (2003), pp. 291-299
[10.]
L. Bergfelt, A. Emilson, M. Lindberg, A. Scheynius.
Quantitative and 3-dimensional analysis of Langerhans cells in basal cell carcinoma. A comparative study using light microscopy and confocal laser scanning microscopy.
Br J Dermatol, 130 (1994), pp. 273-280
[11.]
R.E. Hunger, P.A. Sieling, M.T. Ochoa, M. Sugaya, A.E. Burdick, T.H. Rea, et al.
Langerhans cells utilize CD1a and langerin to efficiently present nonpeptide antigens to T cells.
J Clin Invest, 113 (2004), pp. 701-708
[12.]
L. Bergfelt, O. Larko, M. Lindberg.
Density and morphology of Langerhans cells in basal cell carcinomas of the face and trunk.
Br J Dermatol, 127 (1992), pp. 575-579
[13.]
K.C. Gatter, H.B. Morris, B. Roach, P. Mortimer, K.A. Fleming, D.Y. Mason.
Langerhans’ cells and T cells in human skin tumours: an immunohistological study.
Histopathology, 8 (1984), pp. 229-244
[14.]
T.U. Schreiner, G. Lischka, G. Schaumburg-Lever.
Langerhans’ cells in skin tumors.
Arch Dermatol, 131 (1995), pp. 187-190
[15.]
E. Azizi, C. Bucana, L. Goldberg, M.L. Kripke.
Perturbation of epidermal Langerhans cells in basal cell carcinomas.
Am J Dermatopathol, 9 (1987), pp. 465-473
[16.]
M.R. De Melo Jr, J.L. Araujo Filho, V.J. Patu, M.C. Machado, L.A. Mello, L.B. Carvalho Jr.
Langerhans cells in cutaneous tumours: immunohistochemistry study using a computer image analysis system.
J Mol Histol, 37 (2006), pp. 321-325
[17.]
J.P. McArdle, B.A. Knight, G.M. Halliday, H.K. Muller, G. Rowden.
Quantitative assessment of Langerhans cells in actinic keratosis, Bowen's disease, keratoacanthoma, squamous cell carcinoma and basal cell carcinoma.
Pathology, 18 (1986), pp. 212-216
[18.]
F. Valcuende-Cavero.
Langerhan's cells in skin tumors.
Arch Dermatol, 131 (1995), pp. 1463
[19.]
A.M. Wennberg.
Basal cell carcinoma-new aspects of diagnosis and treatment.
Acta Derm Venereol Suppl (Stockh), 209 (2000), pp. 5-25
[20.]
A. Galan, C.J. Ko.
Langerhans cells in squamous cell carcinoma vs. pseudoepitheliomatous hyperplasia of the skin.
J Cutan Pathol, 34 (2007), pp. 950-952
[21.]
A. Emilson, A. Scheynius.
Quantitative and threedimensional analysis of human Langerhans cells in epidermal sheets and vertical skin sections.
J Histochem Cytochem, 43 (1995), pp. 993-998
[22.]
M.S. Duthie, I. Kimber, R.J. Dearman, M. Norval.
Differential effects of UVA1 and UVB radiation on Langerhans cell migration in mice.
J Photochem Photobiol B, 57 (2000), pp. 123-131
[23.]
A. Tang, M.C. Udey.
Effects of ultraviolet radiation on murine epidermal Langerhans cells: doses of ultraviolet radiation that modulate ICAM-1 (CD54) expression and inhibit Langerhans cell function cause delayed cytotoxicity in vitro.
J Invest Dermatol, 99 (1992), pp. 83-89
[24.]
S.M. Breathnach.
The Langerhans cell.
Br J Dermatol, 119 (1988), pp. 463-469
[25.]
L. Novakovic, S. Lee, G.E. Orchard, J.M. Sheehan, A.R. Young, S.L. Walker.
Effects of solar-simulated radiation dose fractionation on CD1a+ Langerhans cells and CD11b + macrophages in human skin.
Br J Dermatol, 145 (2001), pp. 237-244
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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