Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population

Gandolfo, S; Richiardi, Lorenzo; Carrozzo, Marco; Broccoletti, Roberto; Carbone, M; Pagano, Mario; Vestita, C; Rosso, Stefano; Merletti, Franco

doi:10.1016/s1368-8375(03)00139-8

Cited by 263 publications

(235 citation statements)

References 31 publications

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“…Since the first case was reported in 1910, several studies have suggested that patients with oral lichen planus are at an increased risk of developing cancer (1)(2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical expression of PCNA, p53, bax and bcl-2 in oral lichen planus and epithelial dysplasia

et al. 2009

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A b s t r a c t : T h e p o t e n t i a l fo r m a l i g n a n t transformation of oral lichen planus is still controversial.The expression of proteins related to cell proliferation and apoptosis in oral lichen planus and epithelial dysplasia was analyzed to evaluate the true potential for malignant transformation of this disease. Twentyfour cases of each lesion were subjected to the streptoavidin-biotin technique for identifying the immunohistochemical expression of PCNA, p53, bax, and bcl-2 proteins. Of the 24 cases of oral lichen planus, 14 (58.33%) were positive for PCNA, 10 (41.67%) for p53, 4 (16.67%) for bcl-2 and 12 (50%) for bax, whereas of the 24 cases of epithelial dysplasia, 20 (83.33%) were positive for PCNA, 10 (41.67%) for p53, 6 (25%) for bcl-2, and 20 (83.33%) for bax. Chi-squared test showed no statistically significant differences between the expression of p53 and bcl-2 in oral lichen planus and epithelial dysplasia, regardless of the grade (P > 0.05). However, the expression of PCNA and bax was significantly increased in epithelial dysplasia (P < 0.05). The results of this study showed that alterations in expression of these proteins are observed in oral lichen planus and epithelial dysplasia, suggesting the potential for malignant transformation in both lesions. IntroductionOral lichen planus is a chronic inflammatory disease of unknown cause, and its potential for malignant transformation is a subject of much controversy (1). Since the first case was reported in 1910, several studies have suggested that patients with oral lichen planus are at an increased risk of developing cancer (1-7).However, many authors believe that there is insufficient data to prove an association between oral lichen planus and cancer. For these authors, most cases of malignant transformation are the result of errors in the initial diagnosis of the disease (1,8-13).The true potential for malignant transformation of oral lichen planus can be evaluated by analyzing the expression of proteins related to cell proliferation and apoptosis, as alterations in the expression of these proteins are essential for carcinogenesis (14)(15)(16)(17)(18)(19).Therefore, the aim of this study was to evaluate the immunohistochemical expression of PCNA, p53, bax and bcl-2 proteins in oral lichen planus and epithelial dysplasia in order to explain the controversy regarding the potential for malignant transformation of oral lichen planus and emphasize the importance of long-term follow-up of patients with this disease. Materials and MethodsThe samples used in this study consisted of 24 cases of oral lichen planus and 24 cases of epithelial dysplasia (4 mild, 12 moderate, 8 severe) obtained from the records of

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“…Since the first case was reported in 1910, several studies have suggested that patients with oral lichen planus are at an increased risk of developing cancer (1)(2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical expression of PCNA, p53, bax and bcl-2 in oral lichen planus and epithelial dysplasia

et al. 2009

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“…Insufficient oral hygiene, chronic pressure caused by dental prostheses, infection with papilloma virus, and chronic diseases (such as Plummer-Vinson-syndrome or Lichen planus) are considered further etiological factors. [5][6][7] Clinical stage (according to American Joint Commission on Cancer TNM classification) and tumor grade 8 are established prognostic indicators for OSCC. Cervical lymph node metastases are rather common, whereas distant metastases, involving especially the lung, are seen in advanced stages of disease.…”

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confidence: 99%

STAT1 activation in squamous cell cancer of the oral cavity

Laimer¹,

Spizzo²,

Obrist³

et al. 2007

Cancer

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Thermal degradation of poly(dimethylsilylene) homopolymer (PDMS) and poly(tetramethyldisilylene‐co‐styrene) copolymer (PTMDSS) was investigated by pyrolysis‐gas chromatography and thermogravimetry (TG). PDMS decomposes by depolymerization, producing linear and cyclic oligomeric products, whereas PTMDSS decomposes by random degradation along the chain resulting in each monomeric product and various other combination products. The homopolymer was found to be much less stable than the copolymer. The decomposition mechanisms leading to the formation of various products are shown. The kinetic parameters of thermal degradation were evaluated by different integral methods using TG data. The activation energies of decomposition (E) for the homopolymer and the copolymer are found to be 122 and 181 kJ/mol, respectively, and the corresponding values of order of reaction are 1 and 1.5. The observed difference in the thermal stability and the values of the kinetic parameters for decomposition of these polymers are explained in relation with the mechanism of decomposition. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

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“…Case surveys undertaken recently in various countries have stimulated this controversy even further by suggesting that the malignant transformation rate may range from 0.65% to 6.51%. [1][2][3][4][5] Some authors, however, believe that malignant transformation has not been sufficiently documented to justify the classification of OLP as a precancerous lesion, as proposed by the WHO.6 For these authors, both clinical and histopathological criteria for diagnosing OLP with greater precision are lacking; this situation questions the cases of malignant transformation of OLP reported in the literature. [7][8] Our study revealed that cell alterations, such as an increased nucleus/cytoplasm ratio, irregular distribution of chromatin, thickening of the nuclear membrane, loss of cell adhesion, increased size and number of nucleoli, and bi-or multinucleation may be seen both in OLP and in the epidermoid carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have attempted to assess the malignant transformation potential of OLP. These studies have suggested that a lesion originally diagnosed as OLP has a 6.51% possibility of undergoing malignant transformation in time; [1][2][3][4][5] based on these studies, the World Health Organization (WHO) has classified OLP as a potentially malignant disease. 6 Some authors, however, argue that such transformation has not been sufficiently documented to justify this classification.…”

Section: Introductionmentioning

confidence: 99%

Estudo comparativo das alterações celulares no líquen plano e no carcinoma epidermóide bucal

Sousa¹,

Paradella²,

Brandão

et al. 2009

Rev. Bras. Otorrinolaringol.

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Atualmente, muito se discute a respeito da natureza pré-maligna do líquen plano bucal. OBJETIVO: O presente trabalho tem como objetivo analisar as alterações das células epiteliais presentes no líquen plano bucal, comparando-as com aquelas observadas no carcinoma epidermóide. MATERIAL E MÉTODO: Cortes histológicos de líquen plano bucal e carcinoma epidermóide, corados com hematoxilina-eosina, foram analisados por meio da microscopia de luz. RESULTADO: As alterações mais frequentemente observadas no líquen plano bucal foram aumento da relação núcleo/citoplasma (93,33%), espessamento da membrana nuclear (86,67%) e bi-ou multinucleação (86,67%). O teste t de Student (alfa=5%) revelou haver diferença estatisticamente significante entre o número médio de alterações celulares no líquen plano bucal (5,87±1,57) e no carcinoma epidermóide (7,60±1,81). Quanto aos tipos de alterações, o teste de qui-quadrado também revelou haver diferença estatisticamente significante entre as lesões avaliadas em relação às seguintes alterações celulares: hipercromatismo nuclear, mitoses atípicas, pleomorfismo celular e diferenciação celular anormal (p<0,05). CONCLUSÃO: Apesar de que, em alguns casos, alguns patologistas possam fazer confusão no diagnóstico histopatológico do líquen plano bucal, os resultados obtidos neste estudo mostram que as alterações presentes no líquen plano bucal diferem consideravelmente daquelas observadas no carcinoma epidermóide, evidenciando o quão distintas são estas duas doenças.

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Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: a follow-up study in an Italian population

Cited by 263 publications

References 31 publications

Immunohistochemical expression of PCNA, p53, bax and bcl-2 in oral lichen planus and epithelial dysplasia

Immunohistochemical expression of PCNA, p53, bax and bcl-2 in oral lichen planus and epithelial dysplasia

STAT1 activation in squamous cell cancer of the oral cavity

Estudo comparativo das alterações celulares no líquen plano e no carcinoma epidermóide bucal

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