Density of Langerhans Cells in Nonmelanoma Skin Cancers: A Systematic Review

Table 1

The summary of the studies investigating the number of LCs in BCC.

First author, date	No of cases	The purpose(s) of the study	Langerhans cells immunostaining measurement method	Measurement location	Cell numbers
Azizi, 1987 [18]	12	Analysis of the number and morphologic features of LC in BCC in sun-exposed sites	ATPase activity staining; Calculation in 5-15 fields of vision; Then extrapolated per mm^2	Epidermis overlying the tumours and perilesional skin	IT: PT:
Alcalay, 1989 [22]	34	Analysis of susceptibility of LC in BCC to modification by UV radiation	ATPase activity staining; Calculation in 10-20 fields of vision and extrapolated per mm^2	Epidermis overlying the tumours	Before radiation: After radiation:
Mozzanica, 1990 [48]	6	Analysis of LCs in BCCs before and after 15 days of local treatment with IFN-a2b	Anti-CD1a, HLA-DR antibodies; Calculation in 6 adjacent sections of tumour, extrapolated to 0.25 mm^2	Intra- and peritumoural	Before treatment; IT: PT: During treatment: IT: PT:
Bergfelt, 1992 [15]	65	Analysis of relationship between exposure to UV and the number of LCs in a BCC and normal skin	ATPase activity and anti-CD1a antibody; Calculation per mm^2 in 5-15 random fields of vision	Intra- and peritumoural	IT: ATPase 506/mm^2 (mean), range 262-882; CD1a 426/mm^2 (mean) range 162-677; PT: ATPase 708/mm^2 (mean) range 450-838; CD1a 626/mm^2 (mean) range 450-838
Bergfelt, 1993 [21]	16	Analysis of influence of chronic sun/PUVA exposure on the number of LC and tumour development	Anti-CD1a antibody and ATPase staining; Calculation in 5-15 random fields then extrapolated to per 1 mm^2	Epidermis overlying the tumours	Hand: ATPase: CD1a: Buttock: ATPase: CD1a:
Bergfelt, 1994 [25]	15	Comparison of LC quantification with light microscopy and in vitro confocal microscopy	Anti-CD1a antibodies/CM; Calculation horizontally and vertically by per mm^2 or unit length (0.2 mm)	Interfollicular part of epidermis overlying the tumours	Horizontally: Vertically:
De Melo Jr, 2006 [20]	35	Computerized quantitative analysis of LCs in the cutaneous tumours	Anti-S100 antibody; Calculation in 3 sites of the tumour and extrapolated to area per field (12,234 um^2)	Epidermis overlying the tumours
Rotsztejn, 2009 [23]	20	Analysis of LC number in BCC in the sun-exposed skin	Anti-CD1a antibody; Calculation per 10 HPFs	Intra- and peritumoural	IT: (range 0.0-3.0); PT: (range 3.0-18.0)
Mardones, 2009 [24]	12	Comparison of density and morphology of LCs in the epidermis overlying and surrounding BCC	Anti-CD1a antibody; Calculation per 1 μm^2	Epidermis overlying the tumour and max 2500 μm from its border	IT: PT:
Santos, 2010 [19]	14	Quantification of LC on the epidermis of BCC depending on the local aggressiveness	S100 antibody; Calculation in 20 FCUs per 1 mm^2	Intra- and peritumoural	Low aggressiveness: IT: , PT: High aggressiveness: IT: , PT:
Evangelou, 2012 [49]	8	Analysis of influence of PDT on the number of LC in superficial BCC	Anti-CD1a antibody; Calculation per one HPF	Epidermis overlying the tumours+skin from site distal to the tumour	Before PDT: After 1 hour post-PDT: After 24 hours post-PDT:

BC: basal cells; BCC: basal cell carcinoma; CM: confocal microscopy; FCU: fundamental counting unit; HPF: high-power fields; IFN-a2b: interferon alfa 2b; IT: intratumoural; KC: keratinocytes; PDT: photodynamic therapy; PT: peritumoural; PUVA: psoralen and ultraviolet A; UV: Ultraviolet.