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.

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.