A Study of Oral Premalignant and Malignant Lesions With Immnunoexpression of P53 and Bcl2.

Abstract

CONTEXT- Histopathological examination of oral premaligant and malignant lesions, presenting the fundamental aspects of this cancer, focused on squamous cell carcinoma of the oral cavity (OSCC), moving from its denition and epidemiological aspects, addressing the oral carcinogenesis, oral potentially malignant disorders, epithelial precursor lesions and experimental methods for its study, therapies and future challenges. Also immunoexpression of genes p53 and bcl2 attributed in pathogenesis of development of oral cancer. AIMS- Histopathological analysis of oral premalignant and malignant lesions and immunoexpression of Bcl 2 and p53 in these lesions. MATERIAL AND METHODS- This study was done in department of pathology, GSVM medical college, Kanpur. This was prospective study done from 2019-2021. A total of 200 cases were studied. Specimen received were xed in 10% formalin, processed and sections of 3-4 micron were prepared, stained with H and E. Histopathological examination was done. Anti p53, anti bcl2 antibody was used. Staining and evaluation of immunohistochemistry was done using Ab-5 (clone DO-7) ready to use as monoclonal primary antibody. RESULTS- th Maximum number of cases [24%] were in their 4th and 5 decades of life. Males predominated over females with male:female ratio of 3:1. In present study the most common site of oral mucosal lesions was buccal mucosa which accounted for 42% of total cases. . 88% cases had history of tobacco use, this data strongly suggest close association between tobacco and oral cancer. Most of the pre-neoplastic and neoplastic lesions of oral cavity & oropharynx occur after 20-30 years of exposure to tobacco (37%), followed by 27% each after 0-20 years and 30-40 years of exposure. Gutkha chewing (tobacco) was the commonest observed in almost 50% cases. 69.5%belong to rural areas whereas only 30.5% cases were belong to urban areas. . Among premalignant cases, majority were of leukoplakia (30%) cases.Majority of the malignant cases were well differentiated squamous cell carcinoma. [23%]. Expression of p53 was found in 772.8% of the pre-malignant cases and 90.7% of the malignant lesions of the oral cavity. . It was found that 54.34% of premalignant lesions and 66.6% of malignant lesions showed strong p53 positivity. Most of the premalignant lesion showed mild positivity [50%]. 35% cases showed moderate positivity while none of the premalignant cases showed strong positivity. 52% cases of malignant lesions showed weak positivity. 45% cases showed moderate positivity and 13% had strong positivity. Intensity of staining increases with increasing grade of dysplasia and cancer. CONCLUSION- Pro apoptotic and anti apoptotic genes like p53 and bcl2 play an important role in early pathogenesis of oral cancer and their development from premalignant to malignant lesions. However, they are not the only genes involved as their tumorigenesis seemsmultifactorial.Targettedstudy towards thesegenes canstillbringfutureprospectsofgenetherapy tolight.