Ki-67 expression in oral lichen planus.

PURPOSE: The monoclonal antibody Ki-67 detects a nuclear antigen that is present only in proliferating cells. This is of particular interest for the analysis of the proliferation rates of malignant tumors. The aim of this study was to investigate the malignant potential of oral lichen planus (OLP) on the basis of expression of Ki-67 in healthy individuals (HI), patients with OLP and patients with squamous cell carcinoma (SCC), and to see for any potential interdependence between Ki-67 expression and different clinical and histopathological parameters in OLP. METHODS: Immunohistochemistry for Ki-67 was carried out using an avidin-biotin peroxidase complex method. RESULTS: Ki-67 was more expressed in keratinocytes and lymphocytes of OLP patients compared with HI, but less compared with patients with SCC. Keratinocytes and lymphocytes stained with Ki-67 in OLP patients were significantly higher in males, and in OLP specimens showed less developed civatte bodies (CB) and thickening of the basal membrane (TBM). CONCLUSION: Ki-67 may not serve as prognostic biomarker in oral cancer development from the initially diagnosed OLP, but it could help selecting patients with higher need of follow up for prevention of malignancy.

Oral status in patients receiving 5-fluorouracil for colorectal cancer.

PURPOSE: Oral complications are frequent and troublesome symptoms for those undergoing chemotherapy for cancer. Several antineoplastic agents are proved to have stomatotoxic potential, among them 5-fluorouracil (5-FU). The aim of the present study was to evaluate the oral status and patient experiences during chemotherapy with 5-FU for colorectal cancer. METHODS: Twenty-eight patients treated with 5-day 5-FU plus leucovorin entered this study. Positive data about oral symptoms were taken by anamnesis. Mucositis severity index, gingival index, plaque index, probing pocket depth and bleeding on probing have been used to assess oral mucosa and periodontal status of the patients. Patients were examined prior to chemotherapy and 14 days after the start of the chemotherapy cycle. RESULTS: Mild to moderate subjective complaints concerning oral cavity were reported by 17.9% of patients before and 39.2% of patients after chemotherapy. Clinical examination revealed oral mucosa damage in 10.7% and 35.7% of patients, with mean mucositis score of 0.14 and 0.54 before and after chemotherapy, respectively. Although mean values of all periodontal indices were elevated after chemotherapy, only increase in gingival index was statistically significant (p=0.035). Mucositis was significantly correlated with oral pain (p=0.00), xerostomia (p=0.00), and plaque index (p=0.077), while the correlation between mucositis and the rest of the examined parameters was not significant. CONCLUSION: Oral complications were not highly expressed in this study. Although 5-FU is considered to exert significant stomatotoxic effect, severe mucositis was far less common in this study compared to studies reported elsewhere.

Bcl-2 expression and its possible influence on malignant transformation of oral lichen planus.

PURPOSE: The aim of this study was to investigate the malignant potential of oral lichen planus (OLP) on the basis of the expression of the Bcl-2 marker in healthy individuals (H), patients with OLP and patients with squamous cell carcinoma (SCC), and to establish potential interdependence between expression of Bcl-2 and the different clinical and histopathological parameters in H, OLP, and SCC. METHODS: Immunohistochemistry for Bcl-2 was carried out using an avidin-biotin peroxidase complex method. Tissue sections were treated with mouse monoclonal antibody against Bcl-2 (124, DAKO A/S, Denmark; dilution 1/100). Immunohistochemical parameters measured included total tissue area, total stained area and intensity of stain. RESULTS: Keratinocytes were not Bcl-2 positive in H and were sparsely positive in OLP. The number of lymphocytes stained with Bcl-2 was significantly lower in H as compared to patients with SCC and OLP. Bcl-2 staining was weak to moderate in OLP, and moderate to intense in SCC. Bcl-2-positive lymphocytes were more expressed in older OLP patients (>55 years), and in OLP specimens with orthokeratinized epithelium, less developed acanthosis and highest grade of lymphocyte expression. CONCLUSION: Bcl-2 may not serve as a prognostic biomarker in oral cancer development from OLP, but it could help in selecting patients with higher need of follow up to prevent malignancy.

Expression of Fas/FasL in patients with oral lichen planus.

PURPOSE: To investigate the malignant potential of oral lichen planus (OLP) on the basis of expression of the Fas/FasL markers in healthy individuals (H), OLP patients and patients with squamous cell carcinoma (SCC). PATIENTS AND METHODS: 40 patients with OLP and two control groups were included in this research (H and patients with SCC). Immunohistochemistry for Fas and FasL was carried out using an avidin-biotin peroxidase complex method. RESULTS: Only a low percentage of infiltrating lymphocytes and no keratinocytes were Fas-positive in OLP specimens. The highest percentage of Fas-staining keratinocytes in our survey was identified mostly in H and patients with well-differentiated SCC. In most cases of SCC, OLP and H a high percentage of keratinocytes and lymphocytes were FasL-positive. FasL expression was negatively correlated with the degree of cell differentiation and apoptosis. Taking into consideration that all carcinomas in this survey were highly differentiated, it is not surprising that no statistically significant differences in FasL expression between H, OLP and SCC specimens were detected. CONCLUSION: Downregulation of Fas expression in keratinocytes and lymphocytes of OLP specimens, together with upregulation of FasL, may serve as initial prognostic biomarker in oral cancer development.