Abstract
The oral lichenoid disease (OLD) includes different chronic inflammatory processes such as oral lichen planus (OLP) and oral lichenoid lesions (OLL), both entities with controversial diagnosis and malignant potential. Epidermal growth factor receptor (EFGR) is an important oral carcinogenesis biomarker and overexpressed in several oral potentially malignant disorders. Objectives: To analyze the EGFR expression in the OLD to find differences between OLP and OLL, and to correlate it with the main clinical and pathological features. Material and Methods: Forty-four OLD cases were studied and classified according to their clinical (Group C1: only papular lesions / Group C2: papular and other lesions) and histopathological features (Group HT: OLP-typical / Group HC: OLP-compatible) based in previous published criteria. Standard immunohistochemical identification of EGFR protein was performed. Comparative and descriptive statistical analyses were performed. Results: Thirty-five cases (79.5%) showed EGFR overexpression without significant differences between clinical and histopathological groups (p<0.05). Histological groups showed significant differences in the EGFR expression pattern (p=0.016). Conlusions: All OLD samples showed high EGFR expression. The type of clinical lesion was not related with EGFR expression; however, there are differences in the EGFR expression pattern between histological groups that may be related with a different biological profile and malignant risk. Key words:Oral lichenoid disease, oral lichen planus, oral lichenoid lesion, oral carcinogenesis, EGFR.
Highlights
Oral lichenoid disease (OLD) includes different chronic inflammatory processes with an immunological basis such as oral lichen planus (OLP) and oral lichenoid lesions (OLL) (1), both entities with controversial diagnosis and malignant potential (1-4)
All cases showed an membrane pattern (Mm) expression pattern, but in 31 (70.5%), we observed a cytoplasmatic pattern (Ct) pattern, which was mild and moderatesevere in 13 (41.9%) and 18 (58.1%) cases respectively. This was an interesting finding because main epidermal growth factor receptor (EGFR) expression pattern in non-affected oral mucosa controls was Mm rather than Ct, which in turn was intense in oral squamous cell carcinoma (OSCC) controls
EGFR has an synergic participation with other carcinogenesis biomarkers like cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (26-28). iNOS is associated with EGFR through the stimulation of STAT-3 (Signal Transducer and Activator of Transcription-3) and with COX-2 through the synthesis of prostaglandin (PGE2) (16)
Summary
Oral lichenoid disease (OLD) includes different chronic inflammatory processes with an immunological basis such as oral lichen planus (OLP) and oral lichenoid lesions (OLL) (1), both entities with controversial diagnosis and malignant potential (1-4). To the best of our knowledge, no studies have analyzed the immunohistochemical expression of biomarkers associated with oral carcinogenesis such as the epidermal growth factor receptor (EGFR) in OLP and OLL, using the van der Meij and van der Waal histological diagnostic criteria (2). Despite the strong association of EGFR overexpression with oral carcinogenesis of oral potentially malignant lesions (OPML), few studies have analyzed its expression in OLP (20,21), showing controversial results, and none in OLL. Encouraged by the interesting and reproducible results obtained by van der Meij and van der Waal (7,8) and the strong association of EGFR expression and oral carcinogenesis, the aim of our study is to analyze the differences in EGFR expression in OLD subtypes such as OLP and OLL when diagnostic histological criteria are employed; and to correlate EGFR expression with the main clinical and histological features
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