Original article / research
Prognostic Significance of p53, Ki-67 and Bcl-2 in Leukoplakia and Squamous Cell Carcinoma of the Oral Cavity
Dr. Sonam Sharma,
B-5, Varun CGHS Ltd., Plot No. GH-03, Sector-52, Gurgaon-122003, Haryana, India.
Introduction: Oral Squamous Cell Carcinoma (OSCC) is characterized by diversity in their biological behaviour which in turn forms the basis of deciding management options. It usually arises from Premalignant/Potentially Malignant Lesions (PMLs) of the oral cavity such as leukoplakias, erythroplakias, oral submucous fibrosis, lichen planus etc. Multiple summative genetic alterations occur in these lesions which result in a progression from epithelial dysplasia through in situ carcinoma to an invasive cancer.
Aim: To assess the expression of p53, Ki-67 and Bcl-2 in patients having oral leukoplakia versus patients having OSCC and to correlate their immunoexpression with other clinicopathological parameters. The goal was also to determine if these biomarkers have potential as early indicators of malignancy.
Materials and Methods: This was a retrospective study which was conducted at the Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India, between the period of June 2016 to September 2016. The study comprised of two groups. Group 1 included 30 histologically proven cases of oral leukoplakia and Group 2 included 30 histologically proven cases of OSCC. The OSCC cases were classified and graded on histomorphology. Both the groups were immunohistochemically analyzed for the expression of p53, Ki-67 and Bcl-2 and their expression were correlated with age, sex, anatomical site, histological grading and staining intensity. The results were tabulated and statistically analyzed. A p-value less than 0.05 was considered significant.
Results: A statistically significant increase for Ki-67 expression was seen in OSCC cases than in leukoplakias while the expression of p53 was also similar, but it was statistically insignificant. A significantly high p53 and Ki-67 expression were seen in moderately to poorly differentiated OSCC cases. A statistically significant co-relation was also found between low immunostaining and p53 expression in the cases of leukoplakia and vice-versa in OSCC cases. No statistical significant relation was found between Bcl-2 expression and other parameters in both the groups.
Conclusion: The present study highlights that the immunohistochemical expression of Ki-67 and p53 should be assessed in all the cases of PMLs as these can act as predictive markers for poor prognosis in such cases. These biomarkers also allow identification of tumours with a higher rate of cell growth, thereby permitting the development of prognostic factors which effects the patient’s treatment and the survival time.
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