Quantitative cellular and nuclear volumetric alterations in epithelium from lichen planus lesions of human buccal mucosa

Abstract

Patients with oral lichen planus lesions may represent a relatively high risk population for subsequent development of oral cancer. Little is known of the relative effects of chronic inflammation and the process of malignant transformation itself on the histological structure of transforming epithelia. We have assessed cellular and nuclear volumes in defined basal and spinous cells from normal buccal mucosa epithelium, from epithelium associated with a non-specific chronic inflammatory infiltrate and from lichen planus lesions. Normal (N) tissues were obtained from the margins of non-neoplastic buccal mucosa lesions. Inflammatory (INF) lesions were from areas of the buccal mucosa diagnosed clinically as traumatic irritation without ulceration, and lichen planus (LI) lesions were biopsied from areas exhibiting Wickham's striae. Basal and spinous epithelial cells from normal and pathological human buccal mucosa were measured on haematoxylin and eosin-stained sections imaged through a video camera using a Zeiss VIDAS analyser and from these measurements, nuclear (VN) and cellular (VCELL) volumes were determined. VN and VCELL derived for both basal and spinous strata were similar in N and INF groups but were almost doubled in the LI group. Comparisons between LI and all other groups were significantly elevated. The effects of the inflammatory infiltrate on the oral epithelium in lichen planus and in non-specific inflammation thus differ significantly. VN and VCELL may serve as potential discriminators between benign lesions and premalignant lichen planus.

Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications

“…Although several molecular biologic markers have been suggested to be useful as an additional diagnostic tool in diagnosing OLP, there seems not to be enough scientific evidence yet to apply those as a ‘golden standard’(9–13). Direct immunofluorescent techniques have also been described as additional tool in the diagnostic assessment of OLP (14–20).…”

Nuclear and cellular volumetric alterations in oral lichen planus and lichenoid lesions: A histomorphometric study.

“…Except for a few studies which we compare our findings with (8,9,26) there is little morphometric information in the literature. Previous quantitative studies have dealt with different aspects of the disease and have utilized other parameters.…”

“…These results suggest that oral LL may represent a nonspecific inflammatory stomatitis which possess a lichenoid appearance, and hence do not behave the same way as oral LPs. White et al (8) when comparing normal tissues with nonspecific inflammatory mucosal lesions noted no differences between these two groups. In contrast, they showed that significant differences were present when normal tissues were compared to oral LP and when nonspecific inflammatory lesions were compared to oral LP.…”

“…Morphometry and stereology are quantitative structural techniques which enable objective transformation to be acquired from sections of cells and tissues. These methods have been applied to studies of normal and abnormal tissues (7,8) including lichen planus lesions (9)(10)(11). Their objectivity may find application in differential diagnosis and prognosis (12)(13).…”

A quantitative investigation of immunocytochemically stained blood vessels in normal, benign, premalignant and malignant human oral cheek epithelium

“…The diagnoses were made independently by three authors (YJ; LY and FHW). The criteria for diagnosis were based on previous publications [2,16,29].…”