Department of Dentistry
Βιβλιοθήκη Οδοντιατρικής

2021-05-10

2021

Georgaki Maria

Νικητάκης Νικόλαος Γ. , Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Μαδιανός Φοίβος, Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Λάζαρης Ανδρέας, Καθηγητής, Τμήμα Ιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Τσιχλάκης Κωνσταντίνος, Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Περισανίδης Χρήστος, Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Καλύβας Δήμος, Αναπληρωτής Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.
Πιπέρη Ευαγγελία, Επίκουρη Καθηγήτρια, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ.

Comparative clinical and immunohistochemical study of Laser CO2 ablation vs conventional surgical removal for the management of oral premalignant lesions

English

Comparative clinical and immunohistochemical study of Laser CO2 ablation vs conventional surgical removal for the management of oral premalignant lesions

Background: Oral squamous cell carcinoma (OSCC) is frequently preceded by oral potentially malignant disorders (OPMD), most commonly oral leukoplakia (OL). Several clinical, histopathologic and molecular markers associated with a higher risk of malignant transformation (MT) have been investigated with variable results. However, their propensity to recur after initial treatment has not been thoroughly studied nor correlated with specific prognosticators.
The aim of this study was to evaluate sociodemographic, clinical, microscopic and immunohistochemical parameters of OL lesions as prognostic factors for their recurrence. Also, to assess clinical, microscopic and immunohistochemical changes between primary lesions and their corresponding recurrences.
Materials and Methods: Thirty-three patients with histopathologically confirmed OL managed between 2010-2019 were included in the study. All lesions were removed either by excisional biopsy or by laser ablation following incisional biopsy. The mean follow-up period was 38.6 months. Selected cell cycle and apoptosis-related molecules associated with the Stat3 oncogenic pathway, including pStat3, Bcl-xL, survivin, cyclin D1 and Ki-67, were further analyzed immunohistochemically. Statistical analysis was performed comparing primary lesions (PLs) that recurred or not, as well as PLs and their corresponding recurrences.
Results: A total of 135 OL lesions, including 97 PLs (63 at first visit and 34 at follow-up) and 38 recurrences (occurring at sites of previous PLs) were noticed. Regarding PLs, the most commonly affected site was the buccal mucosa (33%), the mean size was 1.4 (±0.7) cm, 73.2% were homogeneous and 62.9% were classified as mild dysplasia. Out of 97 PLs, 31 (32%) recurred at least once and none of them underwent MT, although a single case of OSCC development at a different site was noticed during follow-up. Among recurrences, the most commonly affected site was the buccal mucosa (31.6%), the mean size was 0.9 (±0.4) cm, 84.2% were homogeneous and 50% and 28.9% were classified as mild dysplasias and hyperplasias, respectively. There was no statistically significant difference among the various parameters in the recurrent vs. non-recurrent PL group, although recurrence was most frequent in non-homogeneous lesions (p=0.087) and dysplastic lesions recurred at a higher percentage compared to hyperplastic lesions (34.5% vs. 15.4%). Regarding the immunohistochemical markers, Bcl-xL and survivin received lower levels in PLs that recurred compared to non-recurrent PLs and were identified as significant risk factors for OL recurrence in the univariate (both molecules) and multivariate (only Bcl-xL) analysis. Finally, recurrences, compared to their corresponding PLs, although smaller, homogeneous and hyperplastic at a higher rate, exhibited increased immunohistochemical expression of oncogenic molecules, especially pStat3 and Bcl-xL.
Conclusion: Our results suggest that parameters associated with recurrence may differ from those that affect the risk of progression to malignancy and support OL management protocols favoring excision and close monitoring of all lesions.

Health Sciences

Oral leukoplakia, Oral potentially malignant disorders, Recurrence, Laser ablation, Cyclin D1, STAT3, Bcl-xL, Survivin, Ki-67, Predictive biomarkers

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https://pergamos.lib.uoa.gr/uoa/dl/object/2944879