Clinical and Immunohistochemical epithelial profile of non-healing chronic traumatic ulcers

Abstract

Background Chronic wounds were previously related to cancer. Chronic Traumatic Ulcers (CTU) are lesions caused by chronic mechanical irritation (CMI) frequently diagnosed in Oral Medicine. Although these conditions may reflect a benign nature, some authors have proposed its relationship with malignant transformation. Currently, there are scarce investigations that evaluate biomarkers within CTU. The aim of this study was to evaluate cell differentiation and proliferation biomarkers patterns of CTU and OSCC through recognized markers such as cytokeratin 19 and Ki67 and correlate it with clinical features of both groups of patients. Material and Methods A Cross-sectional study of adult patients (n=79), both sexes, attended at Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba. The patients were classified into two groups: CTU (n=41), and OSCC (n=38). A subset of specimens were immunolabeled with Ki67 and Ck19. Results The population consisted of 51.9% male and 48.1% female, with an average of 57.0 ± 13.9. years (OSCC group) and 60.9 ± 14.9 years (CTU group). OSCC group presented higher scores for both biomarkers (Ki67 and Ck19), but only there were differences statistically significant for Ki67 ( p =0.032). 25% of non-healing CTU were positive with medium scores of Ck19 and showed an immunohistochemical profile similar to OSCC. The lateral tongue was the most frequent site in both groups. Conclusions The altered immunohistochemical pattern found in many specimens of CTU was also observed in OSCC. The tongue border presents physiological conditions that could offer a suitable environment for the development of neoplastic events associated with CMI. Further studies are needed to understand the underlying mechanisms that could link oral non-healing ulcers with early malignant changes. Key words: Ck19, Ki67, Oral Cancer, Chronic Traumatic Ulcer, Chronic Mechanical Irritation.

An Oral Squamous Cell Carcinoma Based on a Chronic Denture Irritation

“…9 Consequently, OSCC arises most frequently in high-risk areas such as the ventrolateral tongue and the floor of the mouth. 10 However these kind of lesions could also be seen in vestibular sulcus, buccal mucosa and alveolar ridge as happened in our case. 11,12 Clinically, OSCC can be seen in different forms ranging from white plaque to ulcers.…”

Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis

“…Even, without being mutagenic, CMI could generate conditions that could facilitate initiation. Gilligan et al in their cross-sectional study have reported that several specimens of CTU expressed altered immunohistochemical pattern similar to OSCC thereby confirming the role of CMI in oncogenesis [ 47 ]. Studies done on the experimental animal model showed that when combined with chronic trauma, a relatively lower dose of 7,12-dimethyl-benzanthracene (DMBA) was sufficient to induce carcinogenesis.…”

HPV frequency, p16 expression and risk factors for oral leukoplakia from Córdoba, Argentina

“…Receptors from the family of integrins and syndecans are usually overexpressed when the epithelium is exposed to mechanical trauma 32 . CMI generates a hyperproliferative status of the oral epithelium, increasing the persistence, even in suprabasal strata, of immature cells (immunolabelled with cytokeratins 19) with an immunohistochemical pattern similar to basal keratinocytes 33 . This phenomenon linked to CMI could facilitate the persistence and the viral infection of the oral mucosa.…”