Survivin expression in oral lichen planus: Role in malignant transformation

Abstract

Context:Oral lichen planus (OLP) is a potentially malignant disease with a prevalence rate of 0.5–2.2%. It is a T-cell-mediated autoimmune disease, in which cytotoxic CD8+ T-cells trigger apoptosis of the basal cells of oral epithelium. The reported progression of OLP to oral squamous cell carcinoma (OSCC) ranges from 0.4% to 6.5%. Apoptosis plays a major role in the maintenance of tissue homeostasis. The evasion of apoptosis in the form of dysregulation of inhibitors of apoptosis proteins (IAPs) may lead to malignant transformation. Survivin belongs to the second gene family of IAPs, which is overexpressed in many tumors such as OSCC and gastric carcinomas, and its expression is widely involved in apoptosis as well as in tumor metastasis.Materials and Methods:Sections were obtained from the paraffin-embedded archival blocks of patients diagnosed histologically as OLP, and cases with normal epithelium were used for comparison whereas cases with OSCC were used as positive control.Results:We analyzed the expression of survivin in OLP and normal epithelium. Survivin expression with moderate intensity was seen in the cells of basal layer with nuclear positivity in cases of OLP, whereas mild to nil expression was seen in normal epithelium with nuclear and cytoplasmic positivity in different layers.Conclusions:Survivin positivity was seen predominantly in the basal cells of OLP suggesting increased longevity of these cells which in turn might acquire dysplastic changes leading to increased risk of malignant transformation of this premalignant condition. Although the conversion rate may be low, the potential exists in the indolent course of the disease.

Markers of Oral Lichen Planus Malignant Transformation

“…Survivin expression with moderate intensity was observed in the basal layer of OLP lesions. Its expression in normal tissues was modest or absent, while a higher expression of survivin was identified in OSCC samples, suggestive for its role in carcinogenesis [ 72 ].…”

The cellular character of liquefaction degeneration in oral lichen planus and the role of interferon gamma

“…25 So in the present study, we chose IFN-c as a candidate stimulus and OLP has been considered as a premalignant condition, the reported progression of OLP to OSCC ranges from 0.4 to 6.5%. 3,4 It has been proposed that the chronic inflammation and simultaneous wound healing response in OLP may lead to cancer development, 27 but there have been no sufficient investigation to support the hypothesis by now. To further investigate whether IFN-c implicated in malignant transition of OLP, we detected two major downstream mediators of IFN-c receptor, STAT1 and STAT3 28 was reported participate in keratinocyte differentiation and is activated in psoriatic lesion, 29 we could not observe any STAT3 expression in OLP biopsies.…”

Expression of survivin in oral potentially malignant disorders: An immunohistochemical study

“…This study had survivin expression in 100% samples. The majority of cases showed moderate immunoreactivity in basal and suprabasal layers of epithelium whereas a study by Suganya et al [ 22 ] demonstrated mild-to-moderate survivin expression predominantly in the basal layer. The survivin staining intensity was moderate in 60% samples, strong in 27% samples, and mild in 13% of samples.…”