Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, India.
Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences, Wardha, India.
J Oral Pathol Med. 2018 Apr;47(4):410-416. doi: 10.1111/jop.12699. Epub 2018 Mar 12.
The grading of oral epithelial dysplasia (OED) is not applicable to oral submucous fibrosis (OSMF) cases due to the presence of atrophic epithelium. The mucosal margins associated with resected OSCC specimens are often closely related to transformed cells. In this study, we compared the histomorphological alterations (dysplastic features) in the atrophic epithelium of OSMF patients with the mucosal margins of OSCC associated with OSMF (OSCC-OSMF).
We evaluated 17 dysplastic features in 37 patients with OSMF (biopsy site: buccal mucosa) and 37 patients with OSCC-OSMF (mucosal margins involving buccal mucosa) using histopathological staining.
Dysplastic features, such as keratin pearls within rete ridges, nuclear pleomorphism, and atypical mitotic figures, were not observed in the epithelium of the OSMF or OSCC-OSMF groups. Basal cell hyperplasia (P = .016), abnormal superficial mitosis (P = .010), increased nuclear-cytoplasmic ratio (P = .034), and hyperchromasia (P = .031) were predominantly seen in the OSCC-OSMF group. We found no statistically significant differences in the following parameters: irregular epithelial stratification (P = 1.00), loss of basal cell polarity (P = .237), presence of drop-shaped rete ridges (P = .077), increased number of mitotic figures (P = .154), premature keratinization in single cells (P = .499), anisonucleosis (P = .289), anisocytosis (P = .079), cellular pleomorphism (P = .317), and increased number and size of nucleoli (P = .129).
Increased basal cell layer hyperplasia, abnormal superficial mitosis, increased nuclear-cytoplasmic ratio, and hyperchromasia are high-risk features for OSMF, and affected patients should be followed on a priority basis for the early detection of OSCC.
由于存在萎缩的上皮，口腔上皮异型增生（OED）的分级不适用于口腔黏膜下纤维化（OSMF）病例。与切除的 OSCC 标本相关的黏膜边缘通常与转化细胞密切相关。在这项研究中，我们比较了 OSMF 患者萎缩上皮中的组织形态学改变（异型特征）与与 OSMF 相关的 OSCC 的黏膜边缘（OSCC-OSMF）。
我们使用组织病理学染色评估了 37 例 OSMF 患者（活检部位：颊黏膜）和 37 例 OSCC-OSMF 患者（涉及颊黏膜的黏膜边缘）中的 17 种异型特征。
在 OSMF 或 OSCC-OSMF 组的上皮中，未观察到角化珠内的网嵴、核异型性和非典型有丝分裂象等异型特征。基底细胞增生（P=0.016）、异常浅层有丝分裂（P=0.010）、核浆比增加（P=0.034）和深染（P=0.031）主要见于 OSCC-OSMF 组。我们发现以下参数没有统计学差异：不规则上皮分层（P=1.00）、基底细胞极性丧失（P=0.237）、滴状网嵴存在（P=0.077）、有丝分裂象数量增加（P=0.154）、单个细胞过早角化（P=0.499）、核大小不均（P=0.289）、大小不均（P=0.079）、细胞异型性（P=0.317）和核仁数量和大小增加（P=0.129）。
基底细胞层增生增加、异常浅层有丝分裂、核浆比增加和深染是 OSMF 的高风险特征，受影响的患者应优先进行随访，以便早期发现 OSCC。
