Sarathy Niharika Abhay, Niranjan Kochli Channappa, Alrani Devendra, Niranjan Vani, Krishnasamy Nitya, Amberkar Vikram S
Department of Oral and Maxillofacial Pathology, Narsinhbhai Patel Dental College, Sankalchand Patel University, Visnagar, India.
Oral & Maxillofacial Pathology, SDM College of Dental Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka 580 009, India.
J Stomatol Oral Maxillofac Surg. 2025 Mar;126(2):102047. doi: 10.1016/j.jormas.2024.102047. Epub 2024 Sep 5.
Oral verrucous lesions (OVLs) present a diagnostic challenge due to their diverse and often confusing histopathological features. Accurate differentiation is essential for improving diagnosis and predicting prognosis. In addition to assessing overall survival (OS) and disease-free survival (DFS) in verrucous squamous cell carcinoma (VSCC) and conventional OSCC, this study seeks to evaluate the expression of Mcm-2 and Ki-67 in verrucous lesions and oral squamous cell carcinoma (OSCC). These findings will be correlated with the nuclear expression of Mcm-2 and Ki-67.
Ninety tissue samples that were paraffin embedded and formalin-fixed were examined using immunohistochemistry to determine the expression of Mcm-2 and Ki-67. Data on survival and clinico-pathologic characteristics were taken from patient records. Statistical analyses were conducted using Independent T-tests, Cox regression models, and Kaplan-Meier survival analysis.
Mcm-2 was identified as a more sensitive and prognostic marker compared to Ki-67 across the study groups. Mcm-2 overexpression was observed in all cases of verrucous hyperplasia with dysplasia, verrucous carcinoma (VC), VSCC, and conventional OSCC. The 3-year OS and DFS rates were lower in conventional OSCC (75 % and 64.3 %, respectively) compared to VSCC (90 % and 70 %).
This study represents the first initiative to employ both Mcm-2 and Ki-67 as proliferative markers for distinguishing between various oral verrucous lesions. Mcm-2 proves to be a valuable marker for differentiating between potentially malignant and malignant verrucous lesions. However, further validation with larger sample sizes and longer follow-up periods is necessary to confirm its role in predicting OS and DFS.
口腔疣状病变（OVL）因其多样且常令人困惑的组织病理学特征而带来诊断挑战。准确鉴别对于改善诊断和预测预后至关重要。除了评估疣状鳞状细胞癌（VSCC）和传统口腔鳞状细胞癌（OSCC）的总生存期（OS）和无病生存期（DFS）外，本研究旨在评估Mcm-2和Ki-67在疣状病变和口腔鳞状细胞癌（OSCC）中的表达。这些发现将与Mcm-2和Ki-67的核表达相关联。
使用免疫组织化学检查90例石蜡包埋和福尔马林固定的组织样本，以确定Mcm-2和Ki-67的表达。生存和临床病理特征数据取自患者记录。使用独立样本t检验、Cox回归模型和Kaplan-Meier生存分析进行统计分析。
在所有研究组中，与Ki-67相比，Mcm-2被确定为更敏感的预后标志物。在所有伴有发育异常的疣状增生、疣状癌（VC）、VSCC和传统OSCC病例中均观察到Mcm-2过表达。与VSCC（90%和70%）相比，传统OSCC的3年总生存率和无病生存率较低（分别为75%和64.3%）。
本研究是首次将Mcm-2和Ki-67均用作增殖标志物来区分各种口腔疣状病变。Mcm-2被证明是区分潜在恶性和恶性疣状病变的有价值标志物。然而，需要更大样本量和更长随访期的进一步验证来确认其在预测总生存期和无病生存期方面的作用。
