An Immunohistochemical Analysis of Cell Cycle Markers in Oral Mucosal Dysplastic Lesions Treated by Laser Therapy. A Pilot Study

Abstract

Introduction Over the past 15 years, dysplastic oral mucosal lesions have been treated by laser ablation with variable success. A recent study have shown that the type of laser utilized may be important for patient outcome, however, it may also be changes at a cellular level that could be an important factor in determining recurrence outcome. The aims of this study were to assess cellular markers related to oral dysplastic lesions treated by two different laser types. Methods and Materials Twenty patients with a histopathological diagnosis of dysplasia treated with laser ablation between the years 1992 and 2003 were assessed. Tissue blocks of the original diagnostic biopsy specimens were stained with specific cell cycle markers (Cyclin-D1 and Ki67) via immunohistochemistry and presence of the marker were analysed by virtual microscopy. Patients were assessed according to grade of dysplasia [(mild vs. moderate vs. severe) and the type of laser used (Potassium Titanyl Phosphate (KTP) vs. Carbon Dioxide (CO 2 )]. Results No significant difference in Cyclin-D1 and Ki67 levels were found between the two groups with different grades of dysplasia, however, decreased Cyclin-D1 was found in those patients treated with KTP laser (P = 0.028). Conclusions The findings of the present study may indicate cell cycle makers such as Cyclin-D1, may be responsible for the behaviour of dysplastic lesions treated with laser therapy, rather than the type of laser itself, which was reported in previous studies.

Oral medicine and the ageing population

“…Some studies show a positive impact on recurrence rates of active treatment when compared to vigilant monitoring. However, the ultimate malignant transformation rate of these lesions, irrespective of treatment, remains unaltered, supporting the notion of a pre‐programmed mechanism at a molecular level …”