The efficacy of human papillomavirus vaccination in the prevention of recurrence of severe cervical lesions.

OBJECTIVE: A review of current knowledge on the efficacy of human papillomavirus (HPV) vaccination in preventing recurrent severe cervical lesions after excisional surgical treatment. METHODS AND RESULTS: HPV infection is necessary for the development of most cervical precancerous lesions and cervical cancers. Currently, three prophylactic vaccines against HPV infection are available on the market: bivalent Cervarix, quadrivalent Gardasil (formerly Silgard) and nonavalent Gardasil9. All three prophylactic vaccines show high effect in preventing the development of precancerous lesions. The highest efficacy is achieved in the HPV naive population. The surgical excision of severe cervical precancers is the standard approach. However, guidelines regarding HPV vaccination at the time of conisation are not clearly determined. Women diagnosed with severe cervical lesions have mostly not been vaccinated against HPV so far. Therefore, it is beneficial to understand the importance and efficacy of HPV vaccination at the time of conisation in preventing recurrent precancerous lesions. The exact value of HPV vaccination in the context of surgical excision of precancerous lesions remains unclear, but vaccination is definitely valuable in reducing the risk of recurrence. Vaccination timing seems to be more favorable before surgery. However, the ideal timing of vaccination is not established. Some of these questions are likely to be answered by the results of ongoing randomized controlled trials. CONCLUSION: Adjuvant HPV vaccination in the setting of surgical treatment for cervical precancerous lesion is significantly associated with a reduced risk of recurrence. HPV vaccination should be strongly considered as adjuvant therapy, especially in young patients undergoing conisation for a severe cervical lesion.

Esophageal lichen planus: Current knowledge, challenges and future perspectives.

Lichen planus (LP) is a frequent, chronic inflammatory disease involving the skin, mucous membranes and/or skin appendages. Esophageal involvement in lichen planus (ELP) is a clinically important albeit underdiagnosed inflammatory condition. This narrative review aims to give an overview of the current knowledge on ELP, its prevalence, pathogenesis, clinical manifestation, diagnostic criteria, and therapeutic options in order to provide support in clinical management. Studies on ELP were collected using PubMed/Medline. Relevant clinical and therapeutical characteristics from published patient cohorts including our own cohort were extracted and summarized. ELP mainly affects middle-aged women. The principal symptom is dysphagia. However, asymptomatic cases despite progressed macroscopic esophageal lesions may occur. The pathogenesis is unknown, however an immune-mediated mechanism is probable. Endoscopically, ELP is characterized by mucosal denudation and tearing, trachealization, and hyperkeratosis. Scarring esophageal stenosis may occur in chronic courses. Histologic findings include mucosal detachment, T-lymphocytic infiltrations, epithelial apoptosis (Civatte bodies), dyskeratosis, and hyperkeratosis. Direct immuno-fluorescence shows fibrinogen deposits along the basement membrane zone. To date, there is no established therapy. However, treatment with topical steroids induces symptomatic and histologic improvement in two thirds of ELP patients in general. More severe cases may require therapy with immunosuppressors. In symptomatic esophageal stenosis, endoscopic dilation may be necessary. ELP may be regarded as a precancerous condition as transition to squamous cell carcinoma has been documented in literature. ELP is an underdiagnosed yet clinically important differential diagnosis for patients with unclear dysphagia or esophagitis. Timely diagnosis and therapy might prevent potential sequelae such as esophageal stenosis or development of invasive squamous cell carcinoma. Further studies are needed to gain more knowledge about the pathogenesis and treatment options.

Is the Physiological Composition of the Vaginal Microbiome Altered in High-Risk HPV Infection of the Uterine Cervix?

BACKGROUND: Cervical cancer is the fourth most common malignancy and fourth leading cause of cancer death in women worldwide. More than 99.7% of cases are caused by human papillomavirus (HPV), while HPV types 16 and 18 cause over 70% of all cervical cancer cases. In this preliminary study, we aimed to investigate the presence of HPV infection and diversity of bacteria associated with bacterial vaginosis. METHODS: Cervical swabs (n = 21) taken from women aged 21-47 years, in seventeen cases, with different degrees of cervical abnormality, and from four healthy women, were tested for the presence of HPV DNA, as well as the bacterial strains associated with bacterial vaginosis, using the real-time PCR method. RESULTS: HPV16 was the dominant genotype in 53% (9/17) of patients with confirmed precancerous lesions (ASCUS, LSIL, and HSIL). In specimens with confirmed cytological abnormalities and hrHPV infection, we detected a wide diversity of microbes, while the most common species were Gardnerella vaginalis, Atopobium vaginae, Prevotella bivia, Ureaplasma parvum, Ureaplasma urealyticum, Leptotrichia amnionii, Bacteroides ureolyticus, and Sneathia sanguinegens. The presence of pathogens did not differ, depending on the degree of precancerous lesions or HPV type. CONCLUSION: In our work, HPV16 dominated in patients with cervical precancerous lesions. We also suggest an increased bacterial diversity of the vaginal microbiome in patients with cervical lesions, for which the HPV virus is largely responsible.

Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Hypopharynx, Larynx, Trachea and Parapharyngeal Space.

In this article, we review the chapter on tumors of the larynx, hypopharynx, trachea and parapharyngeal space in the new edition of the WHO book, focusing on the new developments in comparison to the previous edition. Squamous cell carcinoma (SCC) and its variants are by far the most common malignancies at these locations, with very limited new insights. The most important is the introduction of new targeted treatment-checkpoint inhibitors, with a new task for pathologists, who may help to predict the response to treatment by analyzing the expression of targeted proteins in biopsy samples. Precancerous lesions remain a controversial topic and, similarly to other organs, it is acceptable to use the terms "dysplasia" or "squamous intraepithelial lesion" (SIL), but there is a slight difference between low-grade dysplasia and low-grade SIL: in the former, mild atypia must be present, while the latter also includes hyperplastic epithelium without atypia. Two approaches have been proposed: a two-tiered system with low- and high-grade dysplasia/SIL and a three-tiered system with an additional category, carcinoma in situ. We are still searching for reliable diagnostic markers to surpass the subjectivity in biopsy diagnosis, with a few potential candidate markers on the horizon, e.g., stem cell markers. Other tumors are rare at these locations, e.g., hematolymphoid, neuroendocrine and salivary gland neoplasms, and are no longer included in Chapter 3. They must be diagnosed according to criteria described in specific chapters. The same holds true for soft tissue tumors, with the exception of cartilaginous neoplasms, which are still included in Chapter 3.

Overexpression of CD44v8-10 in Colon Polyps-A Possible Key to Early Diagnosis.

Background and aims: The majority of colorectal cancers arise from detectable adenomatous or serrated lesions. Here we demonstrate how deregulated alternative splicing of CD44 gene in diseased colon mucosa results in downregulation of standard isoform of CD44 gene (CD44s) and upregulation of variant isoform CD44v8-10. Our aim is to show that upregulation of CD44v8-10 isoform is a possible marker of precancerous lesion in human colon. Methods: We analysed pairs of fresh biopsy specimen of large intestine in a cohort of 50 patients. We studied and compared alternative splicing profile of CD44 gene in colon polyps and adjoined healthy colon mucosa. We performed end-point and qRT PCR, western blotting, IHC staining and flow cytometry analyses. Results: We detected more than five-fold overexpression of CD44v8-10 isoform and almost twenty-fold downregulation of standard isoform CD44s in colon polyps compared to adjoined healthy tissue with p = 0.018 and p < 0.001 in a cohort of 50 patients. Our results also show that aberrant splicing of CD44 occurs in both biologically distinct subtypes of colorectal adenoma possibly in ESRP-1 specific manner. Conclusion: 92% of the colon polyp positive patients overexpressed CD44v8-10 isoform in their colon polyps while only 36% of them had positive fecal occult blood test which is currently a standard non-invasive screening technique. Impact: We believe that our results are important for further steps leading to application of CD44v8-10 isoform as a biomarker of colorectal precancerosis in non-invasive detection. Early detection of colon precancerosis means successful prevention of colorectal carcinoma.

Carcinogenesis and precancerosis transformation of chronic osteomyelitis: 6 cases report and literature review.

BACKGROUND: Malignant transformation is a rare and late complication of chronic osteomyelitis. This study presented the results of six cases of carcinogenesis and precancerosis transformations arising from chronic osteomyelitis. METHODS: Patients who were diagnosed as chronic osteomyelitis and treated in our division were retrospectively retrieved from electronic case system of our hospital. A total of six cases of chronic osteomyelitis patients, confirming with pathological results were included. Not only the characteristics and causes of chronic osteomyelitis, but also time from diagnosis to malignancy, histological types, therapeutic choices and results of treatment were fully incorporated to further study this disease. RESULTS: All 6 cases with chronic osteomyelitis included in the study were male, with average age of 55.67 year-old (ranging from 48 to 66). The average time from onset of osteomyelitis to carcinomatous change was 31 years (ranging from 9 to 50). Two thirds of patients had explicit infection source of trauma, whereas the rest cases had no obvious culprits before osteomyelitis emerging. All 3 patients diagnosed as carcinoma were performed with proximal limb amputation, but therapy strategies varied in the remaining 3 patients in precancerosis stage. After amputation, 1 patient had carcinoma relapsed at the lower portion of his femur. CONCLUSION: Although carcinomatous degeneration exists as a rare complication in chronic osteomyelitis, some suspicious conditions such as failure treatment of refractory ulcer and bulking of cauliflower-like mass should be taken cautiously. Early diagnosis and proximal amputation are essential for prognosis and clinical results.

Expression and Functional Characterization of miR-34c in Cervical Cancer.

BACKGROUND: Cervical cancer is the fourth most common cancer in women and is usually associated with human papillomavirus infection. Viral infections are usually characterized by morphological changes of epithelial cells; however, it is difficult to determine using recently available screening methods whether the changes are caused by productive infection or by malignant disease. Thus, new efforts are required to find novel diagnostic biomarkers of cervical cancer, such as miRNAs, which are small non-coding RNAs involved in the regulation of gene expression. MATERIALS AND METHODS: miR-34c levels in cervical cancer cell lines were determined by the droplet-digital polymerase chain reaction. Changes in miR-34c expression in vitro were achieved by transient transfection with a specific miRNA mimic and inhibitor oligonucleotides. Cell proliferation was analyzed by crystal violet staining followed by spectrophotometric measurements. The effect on migratory properties was studied using a „scratch“ assay. Western blotting analysis was used to determine the expression of selected proteins. RESULTS: The downregulation of miR-34c expression was associated with a slight increase in cellular proliferation and a significant increase in cell migration. The analysis of miR-34c expression performed on a set of 39 dysplastic tissues and 35 samples of healthy controls subsequently revealed a significant difference (p < 0.01) in the level of this miRNA. CONCLUSION: Comparative expression analysis revealed lower expression of miR-34c in cervical precanceroses than in normal untransformed epithelium. in vitro modulation of miR-34c expression revealed its tumor suppressor role in cervical  malignancies. Key words: cervical cancer - HPV - miRNA - HSIL - hsa-miR-34c - precancerosis This work was supported by the projects MEYS - NPS I - LO1413, P206/12/G151 and MH CZ - DRO (MMCI, 00209805). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.  The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Accepted: 16. 7. 2018.

Screening for precancerosis and early gastric cancer in southern Jiangsu province / 中华健康管理学杂志

Objective To investigate the screening results and risk factors for precancerosis and early gastric cancer in southern Jiangsu province. Methods A total of 8 647 participants aged over 40 years were randomly sampled from 7 of 35 counties in Shengze District.Initial screening was performed with antibody testing to determine the pepsinogen Ⅰ/Ⅱratio(PGR),gastrin-17(G-17)level,and prevalence of Helicobacter pylori (Hp) infection, in addition to a questionnaire survey. Based on blood test results, participants were assigned to a low-,moderate,or high-risk group.Those assigned to moderate and high-risk groups were referred for endoscopy. In the low-risk group, 210 participants (30/county) were randomly selected for endoscopy.Results The overall prevalence of Hp infection was 51.2%.Female sex,body mass index,number of family members,and smoking were identified as risk factors based on the results of logistic regression, while educational level, drinking, and history of gastric cancer and digestive diseases were identified as protective factors.Based on the results of gastric functional testing, 2 391 participants(210 of 6 466 in the low-risk group and all participants in the moderate and high-risk groups) were referred for endoscopy.Of 2 381 participants,1 290 underwent endoscopy,with a response rate of 54.0%.According to the endoscopic and pathological findings, 925 participants were diagnosed with gastritis, 233 with atrophic gastritis and intestinal metaplasia,136 with intestinal metaplasia,32 with hyperplastic polyps,26 with mild dysplasia, 3 with moderate dysplasia, 6 with early gastric cancer,and 2 with advanced gastric cancer.The relevance ratio for gastric cancer was 92.5/100 000 in this specific region.Age,history of gastric cancer,Hp infection, over-/under-expression of PGI, PGR, and G-17 level were identified as risk factors for precancerous lesions. In the moderate and high risk groups, the prevalence of precancerous lesions was 24.6% in males and 24.4% in females,with adjustment using propensity score modeling.Conclusion The relevance ratio for early gastric cancer and precancerous lesions was slightly higher in those aged over 40 years in southern Jiangsu Province.It is essential to provide specific intervention and long-term follow-up for those screened for gastric cancer and precancerous lesions.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

BACKGROUND: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions macroscopically challenging to identify and distinguish from initial cancerous foci. OBJECT: Different modalities of diagnostic techniques of laryngeal epithelial lesions exist and they do not offer a single system to make a differential diagnosis. Hence, this meta-analysis aimed to synthesize the validity of each single diagnostic tool to improve laryngeal patient management. METHODS: A systematic review of literature was led searching for articles mentioning the following terms: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward. RESULTS: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a good quality score, 16 were fair. CONCLUSIONS: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and manage patients with voice disorders can be found herein. Our flow-chart allows clinicians in risk-stratify patients and select proper examination modalities to provide appropriate care. Study limitations, together with possible clinical and research implications have been counted.

Caracterización clínico epidemiológica de las dermatosis precancerosas / Epidemiological Clinical Characterization of Precancerous Dermatoses

Introducción: el concepto de precancerosis denomina los procesos morbosos que después de un tiempo más o menos largo se transforman de forma segura o probable en un tumor maligno. Objetivo: determinar el comportamiento de algunas variables clínico-epidemiológicas en pacientes con diagnóstico de lesiones precancerosas. Métodos: se realizó estudio descriptivo transversal en pacientes con dermatosis precancerosas atendidos en el periodo 2010-2011 en la Consulta de Dermatología del Hospital Clínico Quirúrgico Lucía Íñiguez Landín de Holguín. El universo estuvo constituido por los 3 584 pacientes remitidos a la consulta desde las áreas de salud de la provincia Holguín con diagnóstico clínico de lesiones precancerosas. La muestra se conformó con 721 pacientes mayores de 20 años que dieron su consentimiento informado; se excluyeron pacientes con diagnóstico de precancerosis obligadas. Los factores de riesgo estudiados fueron exposición solar, hábito de fumar, piel actínica, fotoenvejecimiento y dermatosis asociadas. Resultados: las dermatosis precancerosas predominantes fueron la queratosis actínica (41,7%) y la atrofia senil (44,9%). Las áreas fotoexpuestas fueron las localizaciones más frecuentes. Las enfermedades asociadas más frecuente fueron otras dermatosis y enfermedades crónicas no trasmisibles. Se distinguieron entre los factores de riesgo la exposición solar (70,3%), la piel actínica (41,3%) y el fotoenvejecimiento (38,6%). Conclusiones: los tipos de dermatosis más frecuentes encontradas fueron la atrofia senil y la queratosis actínica; así como los fototipos I y II de la piel, asociada con factores de riesgo como la exposición prolongada al sol, la piel actínica y el fotoenvejecimiento.

Introduction: the concept of precancerosis included the disease processes that after a longer or shorter period could probably become in a malignancy Objective: to determine the behavior of some clinical and epidemiological variables in patients with precancerous lesions. Methods: a cross-sectional descriptive study of patients with precancerous dermatoses treated from January 2010 to December 2011 in the Dermatology Consultation of Lucia Iñiguez Landin Surgical Hospital of Holguin was carried out. The universe comprised 3 584 patients referred for consultation from health areas of Holguín province with a clinical diagnosis of precancerous lesions. The sample consisted of 721 patients older than 20 years who gave informed consent; patients with a diagnosis of required precancerosis were excluded. The risk factors studied were sun exposure, smoking, actinic skin, photo aging and associated dermatoses. Results: the predominant precancerous dermatoses were actinic keratosis (41.7%) and senile atrophy (44.9%). The exposed areas were the most frequent. The most frequent associated diseases were other dermatoses and non-communicable chronic diseases. The outstanding risk factors were sun exposure (70.3%), actinic skin (41.3%) and photo aging (38.6%). Conclusions: the most common types of skin diseases found were senile atrophy and actinic keratosis as well as the types I and II of the skin, associated with the following risk factors: prolonged sun exposure, actinic skin and photo aging.

Caracterización clínico epidemiológica de las dermatosis precancerosas / Epidemiological Clinical Characterization of Precancerous Dermatoses

Introducción: el concepto de precancerosis denomina los procesos morbosos que después de un tiempo más o menos largo se transforman de forma segura o probable en un tumor maligno.Objetivo: determinar el comportamient o de algunas variables clínico- epidemiológic as en pacientes con diagnóstico de lesiones precancerosas .Métodos: se realizó estudio descriptivo transversal en pacientes con dermatosis precancerosas atendidos en el periodo ,2010, - ,2011, en la Consulta de Dermatología del Hospital Clínico Quirúrgico Lucía Íñiguez Landín de Holguín. El universo estuvo constituido por los, 3 584, pacientes remitidos a la consulta desde las áreas de salud de la provincia Holguín con diagnóstico clínico de lesiones precancerosas. La mue stra se conformó con ,721, pacientes mayores de ,20, años que dieron suconsentimiento informado; se excluyeron pacientes con diagnóstico de precancerosis obligadas. Los factores de riesgo estudiados fueron exposición solar, hábito de fumar, piel actínica, fot oenvejecimiento y dermatosis asociadas.Resultados: l as dermatosis precancerosas predominantes fueron la queratosis actínica ,41,7 por ciento, y la atrofia senil ,44,9 por ciento, Las áreas fotoexpuestas fueron las localizaciones más frecuentes. Las enfermedades asociadas más frecuente fueron otras dermatosis y enfermedades crónicas no trasmisibles. Se distinguieron entre los factores de riesgo la exposición solar , 70,3 por ciento, la piel actínica ,41,3 por ciento, y el fotoenvejecimiento ,38,6 por ciento,Conclusiones: l os tipos de dermatosis más frecuentes encontradas fueron la atrofia senil y la queratosis actínica; así como los fototipos, I, y ,II, de la piel, asociada con factores de riesgo como la exposición prolongada al sol, la piel actínica y el fotoenvejecimiento(AU)

Introduction: t he concept of precancerosis included the disease processes that after a longer or shorter period could probably become in a malignancy Objective: t o determine the behavior of some clinical and epidemiological variables in patients with precancerous lesions.Methods: a cross- sectional descriptive study of patients with precancerous dermatoses treated from January ,2010, to December ,2011, in the Dermatology Consultation of Lucia Iñiguez Landin Surgical Hospital of Holguin was carried out. The universe comprised ,3 584, patients referred for consultation from health areas of Holguín province with a clinical diagnosis of precancerous lesions. The sample consisted of ,721, patients olde r than ,20,years who gave informed consent; patients with a diagnosis of required precancerosis were excluded. The risk factors studied were sun exposure, smoking, actinic skin, photo aging and associated dermatoses.Results: t he predominant precancerous dermatoses were actinic keratosis ,41.3 percent, and senile atrophy ,44.9 percent, The exposed areas were the most frequent. The most frequent associated diseases were other dermatoses and non- communicable chronic diseases. The outstanding risk factors were sun exposure ,70.3 percent, actinic skin 41.3 percent, and photo aging ,38.6 percent ,Conclusions: t he most common types of skin diseases found were senile atrophy and actinic keratosis as well as the types I and II of the skin, associated with the following risk factors: prolonged sun exposure, actinic skin and photo aging(AU)

Meta-analysis of the safety of Yangzhengxiaoji capsule for the treatment of cancer and precancerosis / 中国肿瘤临床

Objective:To evaluate the safety of Yangzhengxiaoji capsules for the treatment of cancer and precancerosis. Methods:Clinical trials and studies were collected by searching Chinese and English databases, including CNKI, WANFANG database, VIP information database, Pubmed, ScinenceDirect Online, and MEDLINE@EBSCO. The clinical data of Yangzhengxiaoji capsule for the treatment of cancer and pre-cancerosis were included. The quality of the included studies was then evaluated. Related data were extracted with reference to Cochrane Handbook 5.0. Afterward, meta-analysis was conducted using Revman 5.0 software. Results:A total of 19 studies focusing on 2 125 patients receiving Yangzhengxiaoji capsules were included and investigated in this meta-analysis. Results showed that the adverse reaction rates of myelosuppression, WBC and platelet decrease, gastrointestinal reaction, nausea/vomiting, and hepatotoxicity were sig-nificantly lower in the trial groups with Yangzhengxiaoji capsule-assisted chemotherapy/radiotherapy than in the control groups with chemotherapy/radiotherapy only (P0.05). Conclusion:Yangzhengxiaoji capsule could be safely administered to treat cancer and precancerosis.

Effectiveness of Microresection Combined with Radiofrequency Ablation under Laryngoscope and Rigid Telescope for Laryngeal Precancerosis / 中国微创外科杂志

Objective To investigate the effectiveness of microresection combined with radiofrequency ablation under laryngoscope and rigid telescope for laryngeal precancerosis. Methods Fifty-one patients with laryngeal precancerosis, which was diagnosed pathologically, were treated with microresection combined with radiofrequency ablation under laryngoscope and rigid telescope. The patients were followed up for over 6 months. Results During a mean of 26-month follow-up (6 months to 4.5 years), 7 of the patients had recurrence (vocal cord leukoplakia in 3, atypical hyperplasia in 2, and laryngeal papilloma in 2); 4 had carcinomatous change (vocal cord leukoplakia in 1, atypical hyperplasia in 2, and laryngeal papilloma in 1);and 2 patients developed laryngeal web after surgical treatment for bilateral vocal cord leukoplakia. One month after the operation, the Jitter, Shimmer, and NNE were decreased significantly (P

Expressions of MG7 in tissue and serum in cancerization risk prediction of gastric precancerosis and its clinical significance / 中国癌症杂志

Background and purpose:Through detection of MG7-Ag expression in various types of gastric mucosa biopsy tissues as well as serum,we studied their correlation and its clinical application value in the role of prediction of gastric precancerosis and its clinical significance.Methods:Using 125 samples of gastric mucosa biopsy tissues and corresponding sera(12 samples of normal gastric mucosa,21 samples of superficial gastritis,24 samples of gastric mucosal erosion and ulcer,15 samples of atrophic gastritis,22 samples of dysplasia,31 samples of gastric cancer)MG7-Ag expression in tissues was detected by SP immunohistochemical two-step staining;enzyme-linked immunosorbent assay was used to detect serum content of antigen MG7.Results:No expression of MG7 was detected in 12 samples of normal gastric mucosa and the positive expression rate of MGT-Ag was 93.55% in 31 samples of gastric cancer.In the order of superficial gastritis,gastric mucosal erosion,ulcer,atrophic gastritis,dysplasia and gastric cancer,expression rate of MG7 was increased sequentially(P

p53 Protein and Skin Sulfhydryl Oxidase Expression in Squamous Cell Carcinoma and precancerosis of Skin / 대한피부과학회지

BACKGROUND: Extensive study of the p53 gene has established its role as a tumor-suppressor gene, and the mutant p53 gene is expressed in a wide spectrum of human malignancy. The conversion of sulfhydryl groups to disulfide bonds in epidermis is carried out by skin sulfhydryl oxidase(SSO) at the junction of the granular layer and horny layers. So it is of interest to investigate the localization and properties of SSO in epidermal keratinocytic neoplasms. OBJECTIVE: Our purpose is to investigate the expression pattern of the p53 protein and SSO and to gain a better understanding of biologic behavior in epidermal keratinocytic neoplasms. METHODS: We investigated the expression pattern of p53 protein and SSO by immunohistochemical method on formalin-fixed, paraffin-embedded tissue specimens in 8 cases of squamous cell carcinomas, several cases of recancerosis(1 Bowen's disease, 1 actinic keratosis, 1 arsenic keratosis) and benign keratinizing disorders(1 verruca vulgaris, 1 condyloma accuminatum and 2 cases of lichen planus). RESULTS: 1. Seven out of 8 cases of squamous cell carcinama(88%) and 1 case of 1 Bowen's disease showed p53 protein expression 2. SSO was weakly present in squamous cell carcinoma and precancerosis compared to the normal skin. In the well differentiated squamous cell carcinoma and Bowen's disease, the presence of SSO was rather diffuse than poorly differentiated squamous cell carcinoma and concentrated in dyskeratotic cells and horn pearls. 3. p53-stained cells or areas were seldom stained with SSO antibody, especially in invading borders of squamous cell carcinomas. CONCLUSION: Our results suggest that p53 mutation is a common genetic change in epidermal tumorigenesis and it can be useful marker of tumor invasion in the squamous cell carcinoma and precacerosis of skin.