Recurrence in Oral Premalignancy: Clinicopathologic and Immunohistochemical Analysis

Diagnostics

Dimitrios Vlachodimitropoulos¹  Christos Perisanidis²  DemosG. Kalyvas²  NikolaosG. Nikitakis³  Evangelia Piperi³  VasileiosIonas Theofilou³  Efstathios Pettas³  Maria Georgaki³  Dimitris Avgoustidis⁴  AndreasC. Lazaris⁵ 

[1] Department of Forensic Medicine-Toxicology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;Department of Oral & Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece;Department of Oral and Maxillofacial Surgery, “Evaggelismos” General Hospital, School of Dentistry, National and Kapodistrian University of Athens, 10676 Athens, Greece;Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;

关键词: oral leukoplakia;    oral potentially malignant disorders;    recurrence;    laser ablation;    cyclin D1;    STAT3;   

DOI  :  10.3390/diagnostics11050872

来源: DOAJ

【 摘 要 】

Oral leukoplakia (OL) has a propensity for recurrence and malignant transformation (MT). Herein, we evaluate sociodemographic, clinical, microscopic and immunohistochemical parameters as predictive factors for OL recurrence, also comparing primary lesions (PLs) with recurrences. Thirty-three patients with OL, completely removed either by excisional biopsy or by laser ablation following incisional biopsy, were studied. Selected molecules associated with the STAT3 oncogenic pathway, including pSTAT3, Bcl-xL, survivin, cyclin D1 and Ki-67, were further analyzed. A total of 135 OL lesions, including 97 PLs and 38 recurrences, were included. Out of 97 PLs, 31 recurred at least once and none of them underwent MT, during a mean follow-up time of 48.3 months. There was no statistically significant difference among the various parameters in recurrent vs. non-recurrent PLs, although recurrence was most frequent in non-homogeneous lesions (p = 0.087) and dysplastic lesions recurred at a higher percentage compared to hyperplastic lesions (34.5% vs. 15.4%). Lower levels of Bcl-xL and survivin were identified as significant risk factors for OL recurrence. Recurrences, although smaller and more frequently homogeneous and non-dysplastic compared to their corresponding PLs, exhibited increased immunohistochemical expression of oncogenic molecules, especially pSTAT3 and Bcl-xL. Our results suggest that parameters associated with recurrence may differ from those that affect the risk of progression to malignancy and support OL management protocols favoring excision and close monitoring of all lesions.

【 授权许可】

Unknown