Expression of p53 and Ki-67 in proliferative verrucous leukoplakia and surrounding epithelium of the tongue: A report of immunohistochemical study

Objective

The aim of the present study was to analyze the expression of p53 and Ki-67 in proliferative verrucous leukoplakia (PVL) and surrounding epithelium (SE) and to characterize SE that may assist in the diagnosis and treatment.

Patient and methods

A 66-year-old man was referred for evaluation and management of white region on the right margin of the tongue. The intraoral examination showed non-homogeneous white speckled and nodular lesion on the right margin of the tongue, lower surface of the tongue and the floor of the mouth. The lesion was treated by surgical excision with appropriate safe margin. The monoclonal antibodies of anti-p53 and anti-Ki-67 antigen were used for immunohistochemical staining. The percentage of positive cells was calculated [labeling index (LI)].

Results

Histological diagnosis was verrucous hyperkeratosis, acanthosis, and basilar hyperplasia with mild dysplasia consistent with a late stage of PVL. p53 and Ki-67 in PVL and SE were expressed in basal cell layer. There was no significant difference of LI of p53 and Ki-67 in PVL and SE.

Conclusions

These findings suggested that SE has the ability to malignant change and wide safe margin is needed for resection of PVL to increase the chances of a favorable outcome.