A Deep Learning Approach for Basal Cell Carcinomas and Bowen’s Disease Recognition in Dermatopathology Image

Basal cell carcinomas and Bowen’s disease (squamous cell carcinoma in situ) are the most common cutaneous tumors. The early diagnoses of these diseases are very important due to their better prognosis. But it is a heavy workload for the pathologists to recognize a large number of pathological images and diagnose these diseases. So, there is an urgent need to develop an automatic method for detecting and classifying the skin cancers. This paper presents a recognition system of dermatopathology images based on the deep convolutional neural networks (CNN). The dermatopathology images are collected from the hospital. The deep learning model is trained using different image datasets. It can be found that the recognition accuracy of the system can be improved by using data augmentation even if the number of the clinical samples are not increased. But the recognition accuracy of the system is the highest when the number of the original histological image is increased. The experimental results that the system can correctly recognize 88.5% of patients with basal cell carcinoma and 86.5% of patients with Bowen’s disease.

Real-world assessment and treatment of locally advanced basal cell carcinoma: Findings from the RegiSONIC disease registry

Background Limited information is available regarding real-world treatment patterns and their effectiveness and safety in patients with locally advanced basal cell carcinoma, including patients not typically represented in clinical trials. The purpose of the current study was to describe how clinicians diagnose and treat locally advanced basal cell carcinoma in the United States. Methods This prospective, multicenter, observational registry study included patients with newly diagnosed, Hedgehog pathway inhibitor–naive locally advanced basal cell carcinoma without basal cell carcinoma nevus syndrome (n = 433) treated at 75 US academic and community practices, including dermatology, Mohs surgery, and medical oncology sites. The main outcomes of this study were treatment patterns and associated effectiveness and safety for patients with locally advanced basal cell carcinoma in real-world settings. Results Determination of locally advanced basal cell carcinoma was mainly based on lesion size (79.6% of patients), histopathology (54.3%), extent of involvement (49.0%), and location (46.2%). Within 90 days of determination of locally advanced disease, 115 patients (26.6%) received vismodegib, 251 (58.0%) received surgery/other (non-vismodegib) treatment, and 67 (15.5%) had not yet received treatment (observation). Vismodegib-treated patients had a higher prevalence of high-risk clinical features predictive for locoregional recurrence than those with non-vismodegib treatment or observation. Clinical response rate was 85.1% with vismodegib and 94.9% with non-vismodegib treatment (primarily surgery). The most common adverse events with vismodegib were ageusia/dysgeusia, muscle spasms, alopecia, and weight loss. Rates of cutaneous squamous cell cancers were comparable between vismodegib and non-vismodegib treatment. Conclusions This prospective observational study offers insight on real-world practice, treatment selection, and outcomes for a nationally representative sample of US patients with locally advanced basal cell carcinoma. For patients with lesions that were not amenable to surgery, vismodegib treatment was associated with effectiveness and safety that was consistent with that observed in clinical trials.

Performance of Ultrasound for Identifying Morphological Characteristics and Thickness of Cutaneous Basal Cell Carcinoma: A Systematic Review

Advances in ultrasound technology and non-surgical treatments of basal cell carcinomas (BCCs) have raised the need to study the performance of high-frequency ultrasound (HFUS) in BCCs. We aimed to assess the performance of HFUS in the evaluation of BCCs to formulate recommendations for its uses and conducted a systematic review of the literature to do so. A search of Central, Medline, Embase, CINHAL, and Web of Science was performed using key/MESH terms “ultrasonography” and “basal cell carcinoma” (January 2005–December 2020). We included primary studies reporting biopsy-confirmed BCCs for which the target intervention was ultrasound assessment at 15 MHz or higher frequency. Thirty articles were included, studying a total of 1,203 biopsy-confirmed BCCs. HFUS provides accurate depth measurements, especially for BCCs >1 mm. The definition of lateral margins in vivo needs further studies; however, ex vivo margin assessment seems convincing. There is a diagnostic role for HFUS in identifying higher recurrence risk BCC subtypes, which can help in risk stratification. Performance of HFUS is significant in BCC management. Pre-surgical scans may support case selection for Mohs. HFUS can improve safety when used to plan brachytherapy treatments, help with case selection and adjunct treatment choice pre-photodynamic therapy. Finally, HFUS can help follow lesions after intervention, particularly non-surgical management, and support the decision to observe or re-intervene. HFUS can enhance clinical practice by providing useful information that cannot be deducted from the clinical examination. It would be recommended to evaluate the extent, mainly depth, and detect the aggressiveness of the BCCs.

Ingensalinae subfam. nov. (Hemiptera: Fulgoromorpha: Fulgoroidea: Inoderbidae), a new planthopper subfamily from mid-Cretaceous Kachin amber from Myanmar

The second genus and species of recently established planthopper family Inoderbidae, Ingensala xiai gen. et sp. nov., is described based on a well-preserved specimen from mid-Cretaceous Kachin (Burmese) amber, and it can be definitely attributed to Inoderbidae mainly based on its head structure, pronotum, and mesonotum without median and lateral carinae and tegmen venation. Ingensala gen. nov. is superficially similar to Eofulgoridium regarding its venation pattern, rather than to the Inoderbidae type genus Inoderbe, and further confirmed that Inoderbidae might descend from the Jurassic planthopper family Fulgoridiidae. The early fork of CuA and the stem CuA bearing many branches also can be found in Jurassic Qiyangiricaniidae and Eocene Weiwoboidae. Ingensala gen. nov. also superficially resembles some Tropiduchidae: Tropiduchinae. The new genus differs from the type genus Inoderbe to a large extent according to its wide head, frons without fastigium, antennae not so elongate, the tectiform condition of wings' position in repose, large, broad and translucent tegmen, triangular basal cell, single CuA1, legs covered with short setae, and the lack of filamentous wax on body. Therefore, two new subfamilies (Inoderbinae stat. nov. and Ingensalinae subfam. nov.) are established for these two genera respectively. The diversification in planthoppers could be the result of pressure of environmental changes during the mid-Cretaceous, and Inoderbidae provides more information for us to understand the Cretaceous stage of Fulgoroidea evolution and diversification.

Altered Epithelial-mesenchymal Plasticity as a Result of Ovol2 Deletion Minimally Impacts the Self-renewal of Adult Mammary Basal Epithelial Cells

Stem-cell containing mammary basal epithelial cells exist in a quasi-mesenchymal transcriptional state characterized by simultaneous expression of typical epithelial genes and typical mesenchymal genes. Whether robust maintenance of such a transcriptional state is required for adult basal stem cells to fuel self-renewal and regeneration remains unclear. In this work, we utilized SMA-CreER to direct efficient basal cell-specific deletion of Ovol2, which encodes a transcription factor that inhibits epithelial-to-mesenchymal transition (EMT), in adult mammary gland. We identified a basal cell-intrinsic role of Ovol2 in promoting epithelial, and suppressing mesenchymal, molecular traits. Interestingly, Ovol2-deficient basal cells display minimal perturbations in their ability to support tissue homeostasis, colony formation, and transplant outgrowth. These findings underscore the ability of adult mammary basal cells to tolerate molecular perturbations associated with altered epithelia-mesenchymal plasticity without drastically compromising their self-renewal potential.