[The use of photodynamic therapy in patients with severe forms of leukoplakia]. / Primenenie fotodinamicheskoi terapii u patsientov s tyazhelymi formami leikoplakii.

OBJECTIVE: The aim the study is to increase the effectiveness of the treatment of severe forms of leukoplakia with the use of photodynamic therapy. MATERIAL AND METHODS: 120 patients with severe forms of leukoplakia were examined. 30 patients were diagnosed with Cr and carcinoma in situ, and therefore they were excluded from the study. In 90 patients, the diagnosis was confirmed by histological and IHC studies. Before the use of photodynamic therapy, the degree of saturation of pathological foci with a photosensitizer was determined by the method of fluorescent diagnostics using the LED device «RFS-400¼. RESULTS: As a result of treatment with photodynamic therapy using a 2nd generation photosensitizer («Photoditazine¼ 0.5% gel penetrator), a significant improvement in the epithelization of lesion elements was observed: in 92% of patients with verrucous leukoplakia and in 83% of patients with erosive leukoplakia. CONCLUSION: The use of photodynamic therapy for the treatment of patients with complicated forms of leukoplakia is an effective method of treatment for this pathology.

[Optimization of the diagnosis of precancerous diseases of the oral mucosa and lips (Manganotti's abrasive precancerous cheilitis and erythroplakia)]. / Optimizatsiya diagnostiki predrakovykh zabolevanii slizistoi obolochki rta i krasnoi kaimy gub (abrazivnyi prekantseroznyi kheilit Manganotti i eritroplakiya).

OBJECTIVE: To optimize the identification of precancerous diseases of the oral mucosa, such as Manganotti's abrasive precancerous cheilitis and erythroplakia of the oral mucosa using markers Ki-67 and keratin 15. MATERIAL AND METHODS: The study group included 17 patients with Manganotti's abrasive precancerous cheilitis and 8 with erythroplakia of the oral mucosa. A histological analysis was carried out to scrutinize the biopsy material of the oral mucosa of the patients. Ki-67 protein and keratin 15 were used to assess the proliferative activity of epithelial cells and the severity of neoplasia. Results. Thirteen patients with Manganotti's cheilitis had dysplasia of varying degrees, and 4 had signs of malignancy. A high proliferative activity of the Ki-67 protein was found in the stratum basal and stratum spinosum of the epithelium. In 5 patients with erythroplakia, according to histological examination, grade 2-3 intraepithelial neoplasia was revealed and 3 patients had cancer in situ. The expression of keratin 15 in all patients with Manganotti's abrasive precancerous cheilitis and erythroplakia in the basal layer tended to decrease with an increase in the degree of dysplasia, however, the appearance of keratin 15 in the cytoplasm of cells located above the basal layer was discovered. CONCLUSION: The use of Ki-67 protein and keratin 15 as immunohistochemical markers in the study of diseases such as Manganotti's abrasive precancerous cheilitis and erythroplakia of the oral mucosa makes it possible to identify the initial signs of malignancy more accurately in the epithelium.