Histopathological evaluation including cytokeratin 13 and Ki-67 in the border between Lugol-stained and -unstained areas

Abstract

Abstract. Lugol's iodine staining (Lugol-staining) has been widely used to detect malignant changes in the cervix uteri and esophagus. However, pathological and histochemical changes in the border between Lugol-stained and -unstained areas in oral epithelial dysplastia and malignant lesions are not well understood. We examined the histological appearance of 20 cases of epithelial dysplasia surrounding squamous cell carcinoma using HE and PAS staining in the borders between Lugol-stained and -unstained areas. Subsequently, differences in the expression of cytokeratin 13 (CK13), an epithelium differentiation marker, and Ki-67, a cell proliferative marker, in those areas were investigated by immunohistochemistry. Lugol-stained areas of all cases showed mild dysplasia or normal epithelium appearance, while Lugol-unstained areas in most cases were diagnosed as moderate/severe dysplasia and carcinoma in situ. PAS reactions were limited or not found in the Lugol-unstained areas as compared to intense positivity in Lugol-stained areas. CK13 and Ki-67 protein expression was significantly different between Lugol-stained and -unstained areas. It was confirmed that epithelia showing precancerous or cancerous features were detected as Lugol-unstained boundary areas. A reduction in glycogen production caused by alterations of cell differentiation and proliferation associated with malignant changes may result in a lack of Lugol-staining.

Loss of cytokeratin 10 indicates malignant transformation in actinic cheilitis

“…2e). These results reinforce previous findings, which confirmed that the loss of CK13 expression in dysplastic epithelium appears to follow the process of malignant transformation [11,13,[15][16][17].…”

“…Although the expression of cytokeratin 10 and 13 has been widely investigated in oral malignant and precancerous lesions [10][11][12][13][14][15][16][17][18], only one of these studies was conducted in actinic cheilitis [10].…”

“…It has been suggested that the cytokeratin 10 (CK10) and 13 (CK13) are markers of dysplastic epithelium, and they can be used to assess the malignant progression in premalignant lesions with dysplasia [10][11][12][13][14][15][16][17]. However, information about the immunohistochemistry pattern of these cytokeratins in actinic cheilitis are scarce.…”

Loss of keratin 13 in oral carcinoma in situ: a comparative study of protein and gene expression levels using paraffin sections

“…[4][5][6][8][9][10][11][12][13][14] Regarding the disappearance of K13 in laryngeal squamous cell carcinomas (SCCs) with definite keratinization tendencies, masking or modification of K13 antigenic sites due to some dysfunction of the K13 gene has been suggested. 11 However, there has been no investigation on the K13 gene expression levels in the oral squamous epithelial lesions lacking the immunohistochemical expression of the K13 protein.…”

Diagnostic Aids in Oral Cancer Screening

“…Yet these techniques are used for research purposes and are not clinically applicable. (Bourhis et al 1996 ;Remmerbach et al 2001;Maraki, Becker, and Boecking 2004;Maraki, Hengge, et al 2006;Maraki, Yalcinkaya, et al 2006;Yamazaki et al 2008 ;Nagamani et al 2010;Mohtasham et al 2010;OHTA et al 2010;Böcking et al 2011). In addition these methods are expensive and are not widely accessible and only expert clinicians can use them for early diagnosis.…”