• Tiago Luders Laurito, Flávia Thomé França, Gislaine Vieira-Damiani, Vitor Bianchin Pelegati, Mariana Ozello Baratti, Hernandez Faustino de Carvalho, Carlos Lenz Cesar, Aparecida Machado de Moraes, Maria Letícia Cintra, and Fernanda Teixeira.
• Department of Pathology, Faculty of Medical Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126. Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil.
• Medicine (Baltimore). 2021 Nov 24; 100 (47): e27925e27925.

AbstractSolid tumors typically contain high levels of fibrillar collagen. The increased stromal collagen deposition usually promotes cancer progression since biochemical and biophysical cues from tumor-associated collagen fibers stimulate neoplastic cells. Few studies have investigated the relationship between Merkel cell carcinoma (MCC) and the extracellular matrix (ECM), but there are no works evaluating collagen.This is an observational, analytical, retrospective study including 11 patients with MCC. Primary tumor-stained sections were evaluated by second harmonic generation microscopy and texture analysis.Peritumoral texture features (area fraction, mean gray value, entropy, and contrast) showed much lower values than normal skin (P < .0001) revealing extensively altered structure of peritumoral collagen fibers. These differences were not significant between tumors with unfavorable and favorable known prognostic factors.Profound changes in collagen fibers present in the stroma accompanying primary MCC may contribute to the aggressive behavior of this tumor. Our results indicate that whatever MCC histological subtype, size or anatomical location, MCC promotes the same type of ECM for its development. As an outlook, therapies using ECM macromolecules or fibroblasts (the architects of ECM remodeling) as target could be useful in the treatment of MCC.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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