Immunohistochemical expression of podoplanin in patients with lichen planus: a cross sectional study
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1
University of Bologna, Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, Italy
Aim: The World Health Organization had included Lichen Planus (LP) among the risk conditions for malignant transformation, even if it is difficult to evaluate the real risk of malignant transformation in LP patients and it is difficult to identify a predictive marker of progression risk to Oral Squamous Cell Carcinoma (OSCC). Immunohistochemical analysis is a simple and reliable method which allows to evaluate the expression of a biomarker which may be correlated with an increased risk of malignant transformation in potentially malignant lesions of the oral cavity. Recently, few authors identified a relationship between dysplasia and podoplanin overexpression in patients with Oral Leukoplakia and proposed podoplanin as a predictive marker to identify Oral Leukoplakias likely to develop into OSCC. In the present cross-sectional study, we investigated a group of consecutive LP to evaluate a possible relationship between altered expression of podoplanin and the presence of dysplasia, and to compare the results with those obtained with other clinical and immunoistochemical variables.
Materials and Methods. The population study consisted of 38 consecutive patients with a clinical and histological diagnosis of LP. The 38 patients were divided into 2 groups: 23 lichenoid lesions in which there was no dysplasia and 15 lichenoid lesions in which dysplasia was present with different degrees (11 LP with presence of mild dysplasia and 4 with presence of moderate dysplasia). Immunoistochemical expression of podoplanin, p53 and Ki67 was analyzed. Lesions with podoplanin expression in the suprabasal layer of the epithelium (≥ pattern 2 in Kawaguchi classification) were considered as positive, whereas the cut off for both p53 and Ki67 overexpression was set to 20% of positive cells. Statistical analysis: A multiple logistic regression model with stepwise selection was fitted to describe the relation between presence/absence of dysplasia (dependent variable) and the following independent variables: Ki67 (<20 vs >20), p53 (<20 vs > 20), podoplanin (<2 vs > 2), patient age (< 65 vs > 65), gender, smoking behavior, site, clinical appearance. A p value < .05 was considered statistically significant in all analyses.
Results. The results of multiple logistic regression showed that podoplanin expression was the only variable significantly related to the presence of dysplasia (T=4.68; p < .01). Indeed, Podoplanin expression was observed in 5 of 23 cases of lichenoid lesions without dysplasia and in 12 of 15 cases of lichenoid lesions with dysplasia (Chi 12,465; p<.05).
Statistical analysis didn’t find a significant relationship between the presence of dysplasia in LP and overexpression of ki67 (Chi 1,870; p=0,1715), overexpression of p53 (Chi 0,035; p=0,8510) and other clinical variables.
Discussion. An altered expression of different biomarkers in LP patients may be uninformative about the risk of OSCC progression, because it might be influenced by tissue inflammation. The present study shows that podoplanin is a promising specific marker related to the presence of dysplasia in LP. If these preliminary results are confirmed in larger prospective cohort studies with an adequate follow up, immunohistochemical expression of podoplanin could be proposed in clinical practice as a marker to discriminate LPs at risk of developing cancer.
References
1. Kawaguchi H, El-Naggar AK, Papadimitrakopoulou V, et al. Podoplanin: a novel marker for oral cancer risk in patients with oral premalignancy. J Clin Oncol 2008;26:354–60.
2. Davide Bartolomeo Gissi, Andrea Gabusi, Achille Tarsitano et al. Podoplanin expression as a predictive marker of dysplasia in oral leukoplakia.
3. de Vicente, J.C., et al., Podoplanin expression in oral leukoplakia: tumorigenic role. Oral Oncol, 2013. 49(6): p. 598-603.
Keywords:
podoplanin,
Lichen Planus,
Dysplasia,
OSCC (oral squamous cell carcinoma),
Immunohistochemistry
Conference:
5th National and 1st International Symposium of Italian Society of Oral Pathology and Medicine., Ancona, Italy, 19 Oct - 20 Oct, 2018.
Presentation Type:
Poster Presentation
Topic:
Oral Diseases
Citation:
Currò
I,
Gabusi
A,
Servidio
D,
Rossi
R,
Felicetti
L and
Gissi
D
(2019). Immunohistochemical expression of podoplanin in patients with lichen planus: a cross sectional study.
Front. Physiol.
Conference Abstract:
5th National and 1st International Symposium of Italian Society of Oral Pathology and Medicine..
doi: 10.3389/conf.fphys.2019.27.00008
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Received:
11 Oct 2018;
Published Online:
09 Dec 2019.
*
Correspondence:
Dr. Ilaria Currò, University of Bologna, Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, Bologna, Emilia-Romagna, 40126, Italy, marcomascitti86@hotmail.it