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Comparative Study
. 2007 Dec;1(2):118-22.
doi: 10.1007/s12105-007-0029-y. Epub 2007 Oct 26.

Comparative study of the expression of p53, Ki67, E-cadherin and MMP-1 in verrucous hyperplasia and verrucous carcinoma of the oral cavity

Hagen Benjamin Edward Klieb  1 , Simon J Raphael
Affiliations
Comparative Study

Comparative study of the expression of p53, Ki67, E-cadherin and MMP-1 in verrucous hyperplasia and verrucous carcinoma of the oral cavity

Hagen Benjamin Edward Klieb et al. Head Neck Pathol. 2007 Dec.

Abstract

Context: Oral verrucous carcinoma (OVC) and oral verrucous hyperplasia (OVH) may be clinically and histologically similar. Problems separating these lesions are compounded by poorly oriented tissue sections and biopsies failing to demonstrate lesional margins.

Objective: To distinguish OVC from OVH utilizing an immunohistochemical panel (p53, matrix metalloproteinase-1, E-cadherin, Ki67) shown to be useful in differentiating pseudoepitheliomatous hyperplasia from oral squamous cell carcinoma of the head and neck.

Materials: Twenty-eight cases of OVH and thirty-two cases of OVC studied. Diagnoses were confirmed by two pathologists. Formalin-fixed, paraffin-embedded archival material was used for immunohistochemistry (avidin-biotin immunoperoxidase technique).

Results: More diffuse nuclear staining of p53 and Ki67 was detected in the OVC cases compared to the OVH cases (P < 0.001). There was statistically significant increased staining within adjacent stromal cells for matrix metalloproteinase-1 (P < .05) in the OVC cases. E-cadherin demonstrated diffuse membranous staining in both groups.

Conclusion: Ki67, p53, and MMP-1 demonstrated significant staining trends. Although a properly oriented hematoxylin-eosin-stained section including normal marginal tissue is considered to be the gold standard for differentiation of OVH and OVC, this immunohistochemistry panel may serve as a useful diagnostic adjunct in difficult cases.

Keywords: Immunohistochemistry; Verrucous carcinoma; Verrucous hyperplasia.

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Figures

Fig. 1
Fig. 1
Verrucous Carcinoma (left) demonstrates well-differentiated squamous epithelium with broad, pushing bulbous rete pegs and marked surface keratinization. Verrucous Hyperplasia (right) shows hyperplastic squamous epithelium with broad and blunt rete ridges, and verrucal surface projections, which are superficial to the adjacent epithelium (H + E, original magnification ×5)
Fig. 2
Fig. 2
Verrucous Carcinoma: Ki67 (left) and p53 (right). Expression of both markers in the basal cell layer and supra basal cells, grade 2 (original magnification ×10)
Fig. 3
Fig. 3
Verrucous Hyperplasia: Ki67 (left) and p53 (right). Ki67 expression is limited to the basal cell layer (grade 1), while there is absent p53 expression (grade 0) (original magnification ×20)
Fig. 4
Fig. 4
MMP-1 expression. Verrucous carcinoma (left) demonstrates expression in the underlying stromal cells and a background staining in the epithelium. Verrucous hyperplasia lacks expression in underlying stromal cells (original magnification ×40)
See this image and copyright information in PMC

References

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