The Correlation of p53, CK13, CK17, and Ki67 Immunostaining Patterns in Assisting the Histopathologic Grading of Oral Epithelial Dysplasia

Introduction

Different markers, such as p53, CK13, CK17, and Ki67, have been used to assist in the histopathologic grading of oral epithelial dysplasia (OED). This study aims to evaluate the correlation between these markers and histopathologic grading.

Materials and Methods

This retrospective study included 65 OED cases: 15 with mild dysplasia, 31 with moderate dysplasia, and 19 with severe dysplasia. Patient age, gender, lesion location, histopathologic grading, and expression patterns of p53, CK13, CK17, and Ki67 immunohistochemical studies were reviewed and analyzed.

Results

In our cases, half of the mild dysplasia and all of the moderate and severe dysplasia cases showed a reverse CK13/CK17 staining pattern. An increased number of Ki67-positive cells, located upward, were frequently associated with moderate and severe dysplasia cases. However, mutated p53 staining patterns were correlated with severe dysplasia (16/19; 84.2%). All our mild dysplasia cases showed a wild-type p53 staining pattern, and fewer than one-third (7/31; 22.6%) of moderate dysplasia cases revealed a mutated p53 staining pattern. The staining patterns were not associated with patient age and gender. Lesions at the ventral and lateral border of the tongue and soft palate were mainly associated with a mutated p53 staining pattern (12/14; 85.7% and 3/3; 100%, respectively). Only 17.5% (7/40) of the lesions on the buccal mucosa were associated with mutated p53.

Conclusions

The alteration in the CK13/17 staining pattern can be used to detect differentiation changes in early OED. Mutation of p53 is most likely a later event and is associated with more advanced OED.