Expression of p53 and Ki-67 in proliferative verrucous leukoplakia and surrounding epithelium of the tongue: A report of immunohistochemical study

Takaaki Kamatani , Chunnan Li , Yoko Yamasaki , Yoshiki Hamada , Seiji Kondo , Satoru Shintani
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Abstract

Objective

The aim of the present study was to analyze the expression of p53 and Ki-67 in proliferative verrucous leukoplakia (PVL) and surrounding epithelium (SE) and to characterize SE that may assist in the diagnosis and treatment.

Patient and methods

A 66-year-old man was referred for evaluation and management of white region on the right margin of the tongue. The intraoral examination showed non-homogeneous white speckled and nodular lesion on the right margin of the tongue, lower surface of the tongue and the floor of the mouth. The lesion was treated by surgical excision with appropriate safe margin. The monoclonal antibodies of anti-p53 and anti-Ki-67 antigen were used for immunohistochemical staining. The percentage of positive cells was calculated [labeling index (LI)].

Results

Histological diagnosis was verrucous hyperkeratosis, acanthosis, and basilar hyperplasia with mild dysplasia consistent with a late stage of PVL. p53 and Ki-67 in PVL and SE were expressed in basal cell layer. There was no significant difference of LI of p53 and Ki-67 in PVL and SE.

Conclusions

These findings suggested that SE has the ability to malignant change and wide safe margin is needed for resection of PVL to increase the chances of a favorable outcome.

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p53和Ki-67在舌增生性疣状白斑及周围上皮中的表达:免疫组化研究报告
目的分析增殖性疣状白斑(PVL)及其周围上皮(SE)中p53和Ki-67的表达,探讨SE的特征,为诊断和治疗提供依据。患者与方法66岁男性患者对舌右缘白区进行评估与处理。口腔内检查示舌右缘、舌下表面及口腔底可见不均匀的白色斑点及结节状病变。病变采用手术切除,并留有适当的安全边缘。采用抗p53和抗ki -67抗原单克隆抗体进行免疫组化染色。计算阳性细胞百分比[标记指数(LI)]。结果组织学诊断为疣状角化过度、棘层增生、基底增生伴轻度不典型增生,与PVL晚期一致。PVL和SE中p53和Ki-67在基底细胞层表达。PVL与SE患者中p53、Ki-67的LI含量差异无统计学意义。结论SE具有恶性改变的能力,需要较宽的安全切缘来切除PVL,以增加良好预后的机会。
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