Vasanthi V, Divya Bose, Ramadoss Ramya, Deena P, Annasamy Ramesh K, Rajkumar Krishnan
Department of Oral Pathology and Microbiology, SRM Dental College, SRMIST, Chennai, Tamil Nadu, India.
Department of Oral Biology, Saveetha Dental College, SIMATS, Chennai, Tamil Nadu, India.
J Oral Maxillofac Pathol. 2022 Oct-Dec;26(4):600. doi: 10.4103/jomfp.jomfp_138_21. Epub 2022 Dec 22.
Reactive oral lesions pose diagnostic difficulties as they mimic each other clinically. A definitive diagnosis is made based on the histopathological presentation of this group of lesion. Stromal microenvironment is the key to the sequence of the stages of these lesions. Stringent quantification of each component of the stroma is important to understand the pathogenesis. The aim is to evaluate inflammation, angiogenesis, and fibrosis in the reactive group of lesions through quantitative analysis.
Blocks of irritation fibroma, inflammatory fibrous hyperplasia, pyogenic granuloma, and normal mucosa were retrieved from the archives and Hematoxylin and Eosin (H&E) and Masson Trichrome staining were done. The severity of inflammation, epithelial thickness, collagen proportionate area, integrated density of collagen, Mean Vascular Area (MVA), Mean Vascular Perimeter (MVP), and Mean blood vessel percentage area (MBVPA) were analysed quantitatively using Image J software version 1.8. The pattern of rete ridges at the epithelium-connective tissue interface was analysed qualitatively.
Inflammatory fibrous hyperplasia presented with severe inflammation (60%). Mean Vascular Percentage Area (MVPA) and Mean Vascular Perimeter (MVP) were increased in pyogenic granuloma. The mean collagen proportionate area and the integrated density of collagen were found to be more in irritation fibroma (64.47%, 2519638.01 ± 810471.58 μm). The epithelial thickness was highest in inflammatory fibrous hyperplasia (62.71 ± 18.86 μm).
Reactive oral lesions are histologically distinct, yet they exhibit considerable overlap depending on the stage of the lesion. A morphometric quantitative exploration of the individual pathogenic components may aid in specific diagnosis.
反应性口腔病变在临床上相互模仿，给诊断带来困难。基于这组病变的组织病理学表现做出明确诊断。基质微环境是这些病变阶段序列的关键。对基质各成分进行严格定量对于理解发病机制很重要。目的是通过定量分析评估反应性病变组中的炎症、血管生成和纤维化情况。
从档案中获取刺激性纤维瘤、炎性纤维增生、化脓性肉芽肿和正常黏膜的组织块，进行苏木精和伊红（H&E）染色及Masson三色染色。使用Image J软件1.8版本对炎症严重程度、上皮厚度、胶原比例面积、胶原积分密度、平均血管面积（MVA）、平均血管周长（MVP）和平均血管百分比面积（MBVPA）进行定量分析。对上皮-结缔组织界面的 rete 嵴模式进行定性分析。
炎性纤维增生表现为严重炎症（60%）。化脓性肉芽肿的平均血管百分比面积（MVPA）和平均血管周长（MVP）增加。发现刺激性纤维瘤的平均胶原比例面积和胶原积分密度更高（64.47%，2519638.01 ± 810471.58 μm）。炎性纤维增生的上皮厚度最高（62.71 ± 18.86 μm）。
反应性口腔病变在组织学上是不同的，但根据病变阶段它们表现出相当大的重叠。对各个致病成分进行形态计量学定量探索可能有助于做出具体诊断。
