Intraepithelial CD163⁺ macrophages in tongue leukoplakia biopsy: A promising tool for cancer screening

Abstract

Objective Oral leukoplakia has mixed and differing histopathological features, and it is thus difficult to reach an accurate histological diagnosis of oral leukoplakia based on a local biopsy alone. We recently demonstrated the significance of CD163+ macrophages in oral carcinogenesis. Herein we sought to determine whether CD163+ macrophages in biopsy specimens of oral leukoplakia help identify the overall histological nature of the lesion. Patients and Methods Twenty‐six patients with tongue leukoplakia who underwent a histological examination by both a preoperative local biopsy and consecutive total excision were enrolled. We evaluated clinicopathological factors and the expression of CD163+ macrophages based on a retrospective comparison of the histological diagnostic concordance between the biopsies and excisions. Results Seventeen patients (diagnostic‐agreement group) were diagnosed with squamous intraepithelial lesion based on both the biopsy and the excision. Nine patients (diagnostic‐discrepancy group) were diagnosed with invasive cancer by excision, although invasive cancer was not observed in their biopsy specimens. Compared to the diagnostic‐agreement group, the diagnostic‐discrepancy group had more tongue leukoplakia with non‐homogenous or high numbers of intraepithelial CD163+ macrophages. Conclusion The evaluation of intraepithelial CD163+ macrophages in local biopsy specimens from tongue leukoplakia patients is a promising tool for cancer screening.

CD163+ Foamy Macrophages Are Associated with the Morphogenesis of Oral Verruciform Xanthoma through Angiogenesis by VEGF Expression: An Immunohistochemical Study

“…On the other hand, studies have reported a few rare cases of OVX associated with malignant lesions [36][37][38]. In addition, several investigators have reported about the correlation between CD163 + macrophages and epithelial dysplasia and the malignancy of oral precancerous lesions [13,14,39,40]. Therefore, we must not overlook the malignant potential of squamous epithelium within the OVXs, which are considered as benign reactive lesions.…”

Intraepithelial Macrophage Expressing CD163 Is a Histopathological Clue to Evaluate the Malignant Potency of Oral Lichenoid Condition: A Case Report and Immunohistochemical Investigation

“…We previously proposed that tongue leukoplakia biopsy, with an intraepithelial lesion in which intraepithelial CD163 + cells are observed, may suggest that invasive cancer is present in the neighborhood of the specimen [ 9 ]. We herein sought to determine whether CD163 + macrophages provide a hint for the evaluation of malignant potency of OLC.…”

“…In this case, whether this patient had invasive cancers initially, or the malignant transformation occurred after the first biopsy, must be carefully discussed. Previously, we demonstrated CD163 + macrophages were infiltrated in the stromal area, but not in the intraepithelial area of nonneoplastic lesions including OLP, oral candidiasis and aphthous stomatitis [ 9 ]. Our findings, overall, indicate that OLC in this study had a high malignant potency, and the small number of intraepithelial CD163 + macrophages observed in the first biopsy specimen should not be overlooked.…”

“…Macrophages are known to be involved in the aggressiveness of various cancers, and it was revealed that CD163 + macrophages predict poor prognosis in patients with OSCC [ 8 ]. Moreover, the significance of macrophages expressing CD163 in tongue leukoplakia, one of the most common OPMDs, was recently reported [ 9 ]. We also demonstrated that CD163 + macrophage infiltration occurs in the oral epithelium depending on the presence of stromal invasion [ 9 ].…”

“…Moreover, the significance of macrophages expressing CD163 in tongue leukoplakia, one of the most common OPMDs, was recently reported [ 9 ]. We also demonstrated that CD163 + macrophage infiltration occurs in the oral epithelium depending on the presence of stromal invasion [ 9 ]. However, few studies have evaluated malignant potency of OLC focusing on macrophages.…”