Sperandio Marcelo, Klinikowski Myriam F, Brown Amy L, Shirlaw Penelope J, Challacombe Stephen J, Morgan Peter R, Warnakulasuriya Saman, Odell Edward W
Department of Oral Pathology, King's College London, Guy's Hospital, London, United Kingdom; Department of Oral Pathology & Medicine, Sao Leopoldo Mandic Dental Institute and Research Center, Campinas-SP, Brazil.
Department of Oral Medicine, King's College London, King's College Hospital, London, United Kingdom.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jun;121(6):643-50. doi: 10.1016/j.oooo.2016.02.008. Epub 2016 Feb 23.
To investigate the potential of image-based DNA ploidy analysis to predict malignant transformation in patients with oral lichen planus (OLP).
DNA ploidy analysis was performed on biopsy samples from 14 patients with OLP who underwent malignant transformation. As controls, 42 OLP lesions showing unusual clinical features suggesting a transformation risk and 68 samples of clinically and histologically typical OLP were included. Cases with dysplasia on initial biopsy were excluded. Eighty fibroepithelial polyps acted as methodologic controls. Epithelial nuclei were isolated from formalin-fixed paraffin embedded biopsy samples and monolayers stained with Feulgen for automated image cytometry to establish DNA content. Ploidy status was correlated to outcome using Kaplan-Meier analysis and log-rank Mantel-Cox tests.
All controls and typical OLP were diploid and none underwent malignant transformation in mean follow-up of 14 years (10-18 years). One unusual OLP developed carcinoma and all were diploid. The 14 patients with transformation developed 21 carcinomas. In the 11 patients who had a prior biopsy, 4 were aneuploid.
DNA ploidy analysis predicted malignant transformation in more than one third (36.4%) of patients with OLP with a preceding biopsy (n = 11). This premalignant nature could not have been diagnosed clinically or by histologic dysplasia assessment.
研究基于图像的DNA倍体分析预测口腔扁平苔藓（OLP）患者恶性转化的潜力。
对14例发生恶性转化的OLP患者的活检样本进行DNA倍体分析。作为对照，纳入42例具有提示转化风险的异常临床特征的OLP病变以及68例临床和组织学表现典型的OLP样本。初始活检有发育异常的病例被排除。80个纤维上皮息肉作为方法学对照。从福尔马林固定石蜡包埋的活检样本中分离上皮细胞核，并用福尔根染色单层细胞进行自动图像细胞术以确定DNA含量。使用Kaplan-Meier分析和对数秩Mantel-Cox检验将倍体状态与结果相关联。
所有对照和典型OLP均为二倍体，在平均14年（10 - 18年）的随访中均未发生恶性转化。1例异常OLP发生癌变，且均为二倍体。14例发生转化的患者发生了21例癌变。在11例曾接受过活检的患者中，4例为非整倍体。
DNA倍体分析在超过三分之一（36.4%）曾接受活检的OLP患者（n = 11）中预测了恶性转化。这种癌前性质无法通过临床诊断或组织学发育异常评估来诊断。
