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High incidence of DNA ploidy abnormalities and increased M cm2 expression may predict malignant change in oral proliferative verrucous leukoplakia
Author(s) -
Gouvêa Adriele F,
Santos Silva Alan R,
Speight Paul M,
Hunter Keith,
Carlos Román,
Vargas Pablo A,
Almeida Oslei P,
Lopes Márcio A
Publication year - 2013
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12036
Subject(s) - aneuploidy , verrucous carcinoma , immunohistochemistry , pathology , ki 67 , ploidy , biology , leukoplakia , malignant transformation , incidence (geometry) , carcinoma , cancer , medicine , gene , chromosome , genetics , physics , optics
Aims To assess the DNA content of cases of oral proliferative verrucous leukoplakia ( PVL ) and correlate the DNA ploidy findings with the expression of M cm2, geminin, and K i67, and with clinicopathological data. Methods and results DNA quantification was performed by image cytometry using the ACIS III A utomated C ellular I maging S ystem. Expression of K i67, M cm2 and geminin was determined by immunohistochemistry. There were 21 cases of PVL , the female/male ratio was 6:1, and the average age was 65.5 years. Seventeen patients (81.0%) did not report tobacco and alcohol consumption. Nine patients (42.9%) developed verrucous or squamous cell carcinoma. Levels of M cm2 expression showed a positive correlation with increasingly severe epithelial changes ( P = 0.03). Twenty patients had their DNA examined by ACIS III , and 19 (95%) showed aneuploidy. The frequency and severity of aneuploidy ( P < 0.0001), the mean values of the DNA heterogeneity index ( P < 0.0001) and the 5 n ‐exceeding fractions ( P = 0.0007) increased according to epithelial alterations. Abnormal DNA content was observed even in the more indolent lesions. Conclusions Mcm2 expression and DNA ploidy analysis could be used to predict areas of malignant transformation. The clinicopathological findings associated with the immunohistochemical and DNA ploidy results support the distinct and aggressive profile of this entity.