Activation and overexpression of the aryl hydrocarbon receptor contribute to cutaneous squamous cell carcinomas: An immunohistochemical study

Abstract

Background: In vitro studies showed that the aryl hydrocarbon receptor (AHR) contributed to the development of cutaneous squamous cell carcinomas, but supporting clinical data are lacking. Methods: Immunohistochemical analysis was used to detect the expression of AHR, CYP1A1, EGFR, and Ki-67 in 10 actinic keratosis (AK) cases, 10 Bowen disease (BD) cases, 20 cutaneous squamous cell carcinoma (cSCC) cases and 20 normal skin samples. H-scores were used to assess the immunoreactivity. Results: Weak positive AHR immunoreactivity was found in all normal skin samples, while strong positive AHR immunoreactivity was found in atypical squamous proliferation (AK, BD and cSCC) cases. H-scores and the rate of strong immunostaining of the atypical squamous proliferation cases were higher than those of normal controls (p<0.01). Nuclear expression of AHR was higher in atypical squamous proliferation cases than in normal controls (p<0.01). H-scores and the nuclear expression rate of AHR were significantly higher in AK and BD cases than cSCC cases (p<0.01). CYP1A1 expression was low and showed no differences among the four studied groups (p>0.05). The H-score of AHR was positively correlated with EGFR expression (r=0.54, p<0.01) in atypical squamous proliferation cases but was not correlated with CYP1A1 (r=-0.17, p=0.295) and Ki-67 (r=-0.48, p=0.222) expression. Conclusion: AHR plays a vital role in cSCC pathogenesis. The overexpression and activation of AHR are involved in the early development of skin cancers. AHR expression correlates with EGFR expression and may influence cell proliferation. AHR is a valuable therapeutic target for skin cancers.