Basal Cell Carcinoma Case Study Solution

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Background
Basal cell carcinoma can be defined as a malignant neoplasm in humans. Basal cell carcinoma originates in the areas between the follicles, subject to a spontaneous mutation. BCC’s can be organized into four categories: nodular, morpheaform, metatypical, and superficial. BCC can be treated generally through SMO inhibitors, for example, vismodegib (Ximena 398). Vismodegib is a molecule inhibitor of the Hedgehog (Hh) pathway (Pricl 389). The pathogenesis of BCC is the inapposite activation of the Hh pathway. A molecule on the Hh pathway binds to the receptor on the PTCH1 resulting in inactivation, which then prevent the inactivation of the SMO receptor (Pricl 390). The two main signaling pathways that are most often affected in tumor
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From these cases 263 were sporadic cases of BCC, while the final 30 tumors were from patients with Gorlin Syndrome. Of the tumors 259 had never been introduced to the drug treatment of vismodegib, 11 were responsive to vismodegib and 23 were resistant to vismodegib (Ximena …show more content…
In whole-exome sequencing, 126 BCC were analyzed and the blood matching sample. These BCC’s were analyzed for specific exons in the gDNA for differences in the base pairs. During the target panel of the cancer gene 163 sporadic BCC’s were analyzed as well as 4 Gorlin syndrome BCC’s. These BCC’s were analyzed against 387 known cancer-related genes. The last method was RNA sequencing of 61 BCC’s and 25 single matched samples of normal epidermis. The normal epidermis samples were compared to the 61 BCC’s to analyze what genes were expressed and not expressed creating an expression profile (Ximena 399.
Results
Mutational signatures of BCC include a profile of BCC that was predictable due to the similarity to UV-induced mutagenesis. This mutagenesis included mostly single nucleotide variability between cytosine and thymine. A small portion concluded that dinucleotide substitutions were involved. The processes of BCC were compared to the processes of melanoma to better understand BCC mutational mechanisms. It was concluded that mutations in BCC primarily arise due to guanine oxidation. Dissimilar to melanoma, where UV-induced mutagenesis involved both cytosines and the oxidation of guanines (Ximena 399). To find BCC drivers, significantly recurrent mutations were identified using and algorithm that used the rate of mutation among base pair. From this algorithm 28 significantly

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