Background: Non-well-differentiated cutaneous squamous cell carcinomas may display a more aggressive behavior. It is important to better define prognostic criteria for these tumors. Methods: This was a retrospective case-control analysis of a squamous cell carcinoma database. Patients with non-well-differentiated and well-differentiated tumors were matched based on site of tumor, age, and immunocompromised status. Comparisons included demographics, histology, immunohistochemical protein expressions (Ki-67, p53, E-cadherin, cyclin D1), and clinical outcomes. Results: Demographic features were similar between cases (n = 30) and controls (n = 30). Non-well-differentiated tumors were larger (1.8 cm versus 1.3 cm, P = 0.08), deeper (0.81 cm versus 0.32 cm, P < 0.0001), and had greater recurrence (P = 0.003). Non-well-differentiated tumors showed increased proliferation rate, Ki-67 index (77% versus 61%, P = 0.001); no significant difference in activity of p53, E-cadherin, and cyclin D1 between the two groups. Conclusions: Tumor differentiation and depth are important pathologic and prognostic criteria for cutaneous squamous cell carcinoma. Immunohistochemistry helps describe patterns of biomarker protein expression and may exemplify aggressive subtypes.
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