Oral Lichen Planus Cell Research Articles

Metabolic changes during malignant transformation in primary cells of oral lichen planus: Succinate accumulation and tumour suppression.

Oral squamous cell carcinoma (OSCC) is usually diagnosed at late stages, which leads to high morbidity. There are evidence that chronic inflammation (eg oral lichen planus [OLP]) was a risk factor of OSCC, but often misdiagnosed or ignored until invasion and metastasis. By applying precision medicine, the molecular microenvironment variations and relevant biomarkers for the malignant transformation from OLP to OSCC can be fully investigated. Several studies pointed out that the metabolic pathway were suppressed in OSCC. However, it remains unclear how the systemic profile of the metabolites change during the malignant transformation. In this study, we examined and compared the mucosa samples from 11 healthy individuals, 10 OLP patients and 21 OSCC patients. Based on the results, succinate, a key metabolite of the tricarboxylic acid cycle pathway, was accumulated in the primary cultured precancerous OLP keratinocytes and OSCC cells. Then, we found that succinate activated the hypoxia‐inducible factor‐1 alpha (HIF‐1α) pathway and induced apoptosis, which could also be up‐regulated by the tumour suppressor lncRNA MEG3. These results suggested the critical roles of succinate and MEG3 in the metabolic changes during malignant transformation from OLP to OSCC, which indicated that succinate, HIF1α and downstream proteins might serve as new biomarkers of precancerous OLP for early diagnosis and therapeutic monitoring. In addition, succinate or its prodrugs might become a potential therapy for the prevention or treatment of OSCC.

MiR-29b interacts with IFN-γ and induces DNA hypomethylation in CD4+ T cells of oral lichen planus

Oral lichen planus (OLP) is an autoimmune inflammatory disease mediated by T cells, in whose pathogenesis CD4+ T helper cells are supposed to play vital roles. MiR-29b has recently been recognized as a crucial regulator in immune response and inflammation. The current research focuses on exploring how miR-29b functions in the immunopathogenesis of OLP. Our findings showed that miR-29b expression in CD4+ T cells was upregulated in OLP, especially in its erosive form. MiR-29b in CD4+ T cells repressed IFN-γ mRNA and IFN-γ secretion, but not T-bet and EOMES; in turn, IFN-γ increased the expression of STAT1 and miR-29b in CD4+ T cells. Moreover, miR-29b in CD4+ T cells suppressed DNMT1 expression and induced global DNA hypomethylation. In conclusion, elevated miR-29b interacts with IFN-γ via a regulatory feedback loop and induces global DNA hypomethylation in CD4+ T cells, which consequently modulates Type 1 T helper immune response, thus contributing to the immune dysregulation of OLP.

Long non-coding RNA DQ786243 modulates the induction and function of CD4+ Treg cells through Foxp3-miR-146a-NF-κB axis: Implications for alleviating oral lichen planus

The present study was aimed to investigate the effects of the long non-coding RNA DQ786243 in the regulation of Treg cells in oral lichen planus (OLP), as well as to evaluate its potential molecular mechanisms. Here we found that the expression of DQ786243 and Foxp3 were both overexpressed in the CD4+ cells from the peripheral blood of OLP patients, and their expression was positively correlated. Meanwhile, compared with the normal CD4+ cells, the frequency of Foxp3+ Treg cells in the OLP CD4+ cells was significantly higher. DQ786243 overexpression in normal CD4+ cells resulted in the upregulation of Foxp3 and the higher frequency of Foxp3+ Treg cells. Furthermore, we found that the induction of Foxp3+ Treg cells by DQ786243 significantly increased its suppressive function, and suppressed the function of other CD4+ T cells such as Th1 and Th17 by decreasing the levels of IFN-γ and IL-17. Moreover, we found that DQ786243 overexpression markedly elevated the expression of miR-146a via regulating Foxp3, and thus inhibiting the NF-κB signaling. In conclusion, these findings indicate that DQ786243 may regulate the induction and function of CD4+ Treg cells through Foxp3-miR-146a-NF-κB axis, implicating a novel insight into understanding the progression of OLP.

Insulin-like growth factor 1 exhibits the pro-autophagic and anti-apoptotic activity on T cells of oral lichen planus

BackgroundOral lichen planus (OLP) is an autoimmune mucocutaneous disease characterized by T cell infiltrating in microenvironment. T cell-mediated immune dysfunctions are of importance in the pathogenesis of OLP. Insulin-like growth factor 1 (IGF1) has profound effects on maintenance of immune functions; however, its specific mechanism in OLP remains unknown. This study aims to explore how IGF1 regulates T-cell immune functions in OLP. MethodsIGF1 in OLP lesions was stained by immunohistochemistry and immunofluorescence. Additionally, proliferation, apoptosis and autophagy of T cells were examined after stimulation with IGF1 for 24 h, respectively. Z-VAD-FMK, a pan-caspase inhibitor, was used to explore IGF1-mediated crosstalk between apoptosis and autophagy. The modulation of IGF1 on ERK and PI3K/mTOR pathway was also analyzed. ResultsIGF1 was increased in OLP lesions and was remarkably co-located with T cells. IGF1 significantly enhanced T-cell proliferation, suppressed apoptosis and induced autophagic flux. Moreover, autophagy was induced by apoptosis inhibitor, Z-VAD-FMK, thereby reducing death of T cells. IGF1 could facilitate Z-VAD-FMK-induced autophagy and then decrease proportion of apoptotic T cells. IGF1-treated T cells also showed elevated phosphorylation of ERK, PI3K and mTOR. ConclusionsIGF1 inhibited apoptosis and promoted autophagy in T cells, potentially contributing to the pathogenesis of OLP.

Expression of Cluster of Differentiation 1a-Positive Langerhans Cells in Oral Lichen Planus.

Background/Purpose:Lichen planus is a T-cell-mediated mucocutaneous disorder characterized histopathologically by a band of chronic inflammatory cells in the subepithelial zone and degeneration of basal layer. The present study was aimed to evaluate the distribution and quantitative assessment of cluster of differentiation 1a (CD1a)-positive Langerhans cells (LCs) in oral lichen planus (OLP), thus to determine the role of LCs pertaining to the changes occurring in OLP.Materials and Methods:Five cases of normal oral mucosa and 20 cases of OLP were immunostained with CD1a antibody; the positive cells were counted manually in the photomicrographs and statistically analyzed using t-test, Mann–Whitney test, and Wilcoxon signed-rank test.Results:The average percentage of CD1a-positive LCs in normal subjects was 0.9%, and in the OLP cases higher percentage was observed (3.93%). The statistical comparison of these two parameters was significant (P=0.018). The degree of basal cell degeneration and density of subepithelial infiltrate on statistical comparison with the concentration of CD1a-positive LCs showed significant results.Conclusion:LCs play a pivotal role in the recruitment of CD4+ and CD8+ cells to the subepithelial region and basal keratinocytes apoptosis. A small number of study subjects, assessment of only CD1a molecule and LCs in the epidermis only were a few of the drawbacks of the study.

Quantitative and Qualitative Analysis of Mast Cells in Oral Lichen Planus and Its Effect on Basement Membrane Using Special Stains.

Background:Oral lichen planus (OLP) is characterized histologically by epithelial basal cell destruction and a dense subepithelial lymphocytic infiltrate. Mast cells (MCs) play a role in the pathogenesis and progression of the disease causing changes in the basement membrane (BM). BM is seen as continuous or fragmented, distinct or indistinct, and afibrillar or fibrillar extensions.Aims and Objectives:This study was done to demonstrate the BM using acriflavine stain in addition to hematoxylin and eosin (H-E) stain. An attempt was also made to study MC using Azure A stain and assess the degree of changes in the thickness of BM associated with degranulated MC in patients with OLP.Materials and Methods:A total of 66 paraffin-embedded tissue sections which included 30 inflamed gingival mucosa (IGM) and 36 OLP were stained with H-E stain, Azure A, and fluorescent periodic acid–acriflavine stain.Results:MC density was higher in OLP when compared with MC in IGM. Degranulated MCs were found in abundance in OLP. Thickness of BM was significantly less in OLP when compared with IGM. Significant fragmentation was seen in OLP when compared with BM of IGM.Conclusion:Degranulated MC in OLP may or may not alter the quality of BM but definitely seems to influence the thickness of the BM both directly and indirectly.

Role of Mast Cells in Oral Lichen Planus and Oral Lichenoid Reactions.

Introduction Oral lichen planus (OLP) is a chronic T cell mediated disease of oral mucosa, skin, and its appendages with a prevalence of 0.5 to 2.6% worldwide. Oral lichenoid reactions (OLR) are a group of lesions with diverse aetiologies but have clinical and histological features similar to OLP, thereby posing a great challenge in differentiating both lesions. Mast cells are multifunctional immune cells that play a major role in the pathogenesis of lichen planus by release of certain chemical mediators. Increased mast cell densities with significant percentage of degranulation have been observed as a consistent finding in pathogenesis of oral lichen planus. Aim The current study was aimed at quantifying the mast cells in histopathological sections of OLP and OLR thereby aiding a means of distinguishing these lesions. Materials and Methods The study group involved 21 cases of oral lichen planus, 21 cases of oral lichenoid reactions, and 10 control specimens of normal buccal mucosa. All the cases were stained with Toluidine Blue and routine haematoxylin and eosin and the mast cells were quantified. Statistical Analysis Used The results were analyzed using the Kruskal–Wallis test and an intergroup analysis was performed using Mann–Whitney U test. Conclusion The number of mast cells showed an increased value in oral lichen planus when compared to oral lichenoid reaction and thus an estimation of mast cells count could aid in distinguishing OLP from OLR histopathologically.

Phenotypic alteration of basal cells in oral lichen planus; switching keratin 19 and desmoglein 1 expression.

In oral lichen planus, extracellular matrix and basal cells are damaged by T-lymphocytes. As a consequence, changes in expression of collagen fibers within the connective tissue and cytoskeletons of the epithelial tissue can be observed. With the goal of examining the characteristic changes undergone by basal cells as a consequence of T-lymphocytes damage in oral lichen planus, we investigated protein expression in the epithelial-connective junction. We selected 20 cases of oral lichen planus and 5 control samples of buccal mucosa. Subsequently, we divided the oral lichen planus cases into thin and thick parts based on the mean values of epithelial thickness from the control samples, and counted the positive rate of collagen IV, keratin 19, desmoglein 1, and Ki-67. Collagen IV immune-reactivity partially disappeared or thickened in oral lichen planus. The keratin 19 positive rate in oral lichen planus cases was significantly lower than in the controls. Desmoglein 1 positive rate of the thick part was significantly higher compared to the thin part of oral lichen planus. Thus, modifications in basal cells with both reduced keratin 19 expression and alterations of desmoglein 1 expression suggest that in oral lichen planus, as a consequence of cell injury or regeneration in the interface area, there is a disappearance of the "true basal cell nature".

Memory T Cells (CD45RO) Role and Evaluation in Pathogenesis of Lichen Planus and Lichenoid Mucositis.

Memory T cells have the ability to survive in a quiescent state for longer periods and are responsible for the rapid responses on subsequent exposure to antigen. Analyzing memory T cells in Oral Lichen planus (OLP) and Lichenoid Mucositis (LM) suggest that these cells may play a role in the immunopathogenic mechanisms. To identify and evaluate Memory T cells in Lichen Planus (LP), Lichenoid Mucositis (LM) and Normal Mucosa (NM) using CD45RO monoclonal antibody immunohistochemically. A total of 30 cases (15 cases of OLP and 15 cases of LM) clinically and histopathologically diagnosed, and 10 cases of NM were stained for CD45RO monoclonal antibody, immunohistochemically using Biotin Streptavidin method. Staining intensity of CD45RO expression was statistically analysed using Chi-square Test. The present study demonstrated a higher expression of CD45RO in connective tissue layer of OLP (53.3% intense staining) when compared to LM (20% intense staining) and no intense staining in NM. The difference in staining intensity pattern between the study groups was statistically significant (p=0.014). This study demonstrates a statistically significant rise in memory T cells in LP than in LM, indicating the possible different immunopathogenic mechanisms.

Phenotypically non-suppressive cells predominate among FoxP3-positive cells in oral lichen planus.

Oral lichen planus (OLP) is a common T-cell-dominated oral chronic inflammatory disease occurring in periods of remission, quiescence, activity with pronounced inflammation, and acute ulceration. Cell infiltrates in OLP contain varying numbers of CD4+ T cells expressing the transcription factor FoxP3. FoxP3+ CD4+ T cells are, however, a heterogeneous cell population containing suppressive and non-suppressive cells, and their distribution in infiltrates from OLP is unknown. Biopsies were taken from normal oral mucosa (n = 8) and OLP lesions (n = 19), and a set of in situ methods for the determination of the functional phenotype of FoxP3+ CD4+ T cells was applied. Numbers of FoxP3+ CD4+ T cells were highest in the atrophic form of the disease, yet low in the ulcerative form. The main FoxP3+ CD4+ T-cell population observed was FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s- , a phenotype delineating a non-suppressive subset. Numbers of cells with an actively suppressing phenotype (FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s+ ) were, however, about twice as high in reticular lesions as compared with the atrophic form. Many FoxP3+ CD4+ T cells expressed T-bet, the hallmark transcription factor for IFN-γ-producing T cells, indicating that they may enhance immune and inflammatory responses rather than suppress them. The absence of actively suppressing FoxP3+ CD4+ T cells may in part explain why OLP is a remarkably persisting condition, in spite of the presence of substantially high numbers of FoxP3+ CD4+ T cells. The findings emphasize that it is crucial to examine not only numbers but also functional phenotype of FoxP3+ CD4+ T cells in human tissues.

CD1a+ dendritic cells in oral lichen planus and amalgam lichenoid reaction

To evaluate and compare the number of CD1a+ dendritic cells (DCs) in oral lichen planus (OLP), amalgam lichenoid reaction (ALR), and normal oral mucosa (NOM). Fourteen cases of OLP and ALR, diagnosed both clinically and histologically, were obtained from an archive of an oral pathology service. Seven specimens of NOM were collected and served as controls. Immunohistochemistry was used to identify CD1a+ DCs. Densities were calculated using specimens of epithelium and lamina propria. For OLP and ALR, specimens of lamina propria included cells from inflammatory infiltrate (region A), and from below inflammatory infiltrate (region B). Comparisons and statistical analyses were performed among OLP, ALR, and NOM. A higher density of CD1a+ DCs was observed in OLP compared to ALR in region A (P<.05) and regions A+B (P<.05). A higher density of CD1a+ DCs was also observed in OLP compared with NOM in the regions A+B (P<.05). Statistically significant differences were not observed for analyses involving epithelial tissue. The observation that there is a lower quantity of DCs in ALR specimens compared with specimens from individuals with OLP suggests that the role for DCs in the 2 diseases may be different. The difference in cell density could be used in the differential diagnosis of these 2 diseases, but the overlapping intervals in the statistical analysis may limit the application of this approach in surgical practice.

Altered Autophagy-Associated Genes Expression in T Cells of Oral Lichen Planus Correlated with Clinical Features

Oral lichen planus (OLP) is a T cell-mediated inflammatory autoimmune disease. Autophagy has emerged as a fundamental trafficking event in mediating T cell response, which plays crucial roles in innate and adaptive immunity. The present study mainly investigated the mRNA expression of autophagy-associated genes in peripheral blood T cells of OLP patients and evaluated correlations between their expression and the clinical features of OLP. Five differentially expressed autophagy-associated genes were identified by autophagy array. Quantitative real-time RT-PCR results confirmed that IGF1 expression in the peripheral blood T cells of OLP patients was significantly higher than that in controls, especially in female and middle-aged (30–50 years old) OLP patients. In addition, ATG9B mRNA levels were significantly lower in nonerosive OLP patients. However, no significant differences were found in the expression of HGS, ESR1, and SNCA between OLP patients and controls. Taken together, dysregulation of T cell autophagy may be involved in immune response of OLP and may be correlated with clinical patterns.

Expression of CD1a by Langerhan's Cells in Oral Lichen Planus - A Retrospective Analysis.

Langerhan's Cells (LCs) are dendritic cells of the oral epithelium which play a role in a series of oral lesions from gingivitis to oral cancer. Oral Lichen Planus (OLP) is an oral mucosal T-lymphocyte mediated immunologic reaction to an unidentified putative antigen or allergen. The aim of this study was to quantify the presence of immature LCs in OLP comparing them with normal epithelium. A retrospective study using 30 of OLP cases were conducted. Immunohistochemistry was performed using polyclonal anti-CD1a antibodies to identify LCs in 10 cases of normal tissue and 30 samples of OLP. The distribution of LCs among lesional tissue and normal mucosa was analysed using Mann-Whitney U test. LC population in OLP was significantly higher when compared to the normal epithelium (p<0.001). The increase in LCs indicates the active role played during the antigen detection in OLP and subsequent presentation to T-lymphocytes.

Declined hTERT expression of peripheral blood CD4(+) T cells in oral lichen planus correlated with clinical parameter.

Oral lichen planus (OLP) is a chronic, T-cell-mediated inflammatory autoimmune disease. Human telomerase reverse transcriptase (hTERT), a catalytic subunit bearing the enzymatic activity of telomerase, may have a unique function in regulating the activation, proliferation, and function of T lymphocytes. The goal of this study was to investigate the expression of hTERT in CD4(+) and CD8(+) T cells from patients with OLP and its correlation with clinical parameter. The disease severity of OLP was assessed by RAE (reticular, atrophic, erosive) scoring system. Expressions of hTERT in CD4(+) T cells and CD8(+) T cells isolated from peripheral blood of patients with OLP were detected by real-time PCR, and their correlations with clinical features were analyzed. hTERT mRNA levels in CD4(+) T cells of OLP were significantly lower than that of controls, while the levels in CD8(+) T cells showed no statistical difference. The expression of hTERT in CD4(+) T cells and CD8(+) T cells was neither associated with disease severity nor gender. CD4(+) T cells of OLP patients with the age ≤50 had markedly decreased hTERT levels compared with controls, but CD8(+) T cells did not. A divergent hTERT pattern between CD4(+) and CD8(+) T cells was implicated in OLP. Decreased hTERT in CD4(+) T cells might be responsible for the immune dysfunction in OLP.

Programmed Cell Removal Biomarkers Calreticulin and CD47 Implicated In Oral Lichen Planus

To investigate the expression of the programmed cell removal markers, Calreticulin and CD-47, involved in the eat me don't eat me signal in cancer pathogenesis in the epithelial and inflammatory cells of oral lichen planus (OLP) patients, and to investigate the association with clinical parameters such as Keratotic (KLP) and atrophic erosive(A/ELP)forms.

Regulation of immune cells in oral lichen planus.

Oral lichen planus (OLP) is an immunological disease and while it is understood that the T cell subsets, FoxP3(+) Tregs and IL17(+) Th17 cells are involved in immune regulation, little is known about their presence in OLP. The aims of this study were to compare the number of cells expressing FoxP3 or IL-17 in OLP with non-specifically inflamed oral mucosa and to determine which cell types expressed FoxP3 and/or IL-17 and their distribution. Immunohistochemistry was used to investigate the presence of FoxP3(+) or IL-17(+) cells in 12 control cases and 17 cases of OLP. These results were analysed quantitatively and qualitatively. Double-labelling immunofluorescence (IF) was used to determine the type of cell expressing FoxP3/IL-17 and these results were analysed qualitatively. OLP displayed significantly more FoxP3(+) cells (mean 79.3 vs. 20.6 cells/defined area, p < 0.0001) and fewer IL-17(+) cells (mean 1.05 vs. 3.30 cells/defined area, p = 0.0003) than non-specific inflammatory cases. The majority of FoxP3(+) cells were in the sub-epithelial infiltrate, while IL-17(+) cells were deeper in the stromal tissues. IF showed that FoxP3(+) cells co-localised with T cells, while the IL-17(+) cells did not. These results show that the balance between Tregs and IL-17(+) cells is altered in OLP, thus supporting the proposition that disturbance in local immune regulation is important in the pathogenesis of OLP. The observation that the IL-17(+) cells were mast cells has not previously been reported in OLP and again raises questions about the role of mast cells in this condition.

Cytomorphometric analysis of exfoliated cells in oral lichen planus.

Background:Tumors are distinguished from normal tissues partly by their pronounced variability of cellular and nuclear dimensions. Therefore, such factors may be an indicator to assess whether the cells are malignant or not. Exfoliative cytology is a reliable tool in assessing such changes in the uterine cervix and has been used in the oral cavity also with success. The aims and objectives of the following study were to evaluate the malignant changes by assessing the quantitative parameters such as cytoplasmic diameter, cytoplasmic perimeter and cytoplasmic area (CD, CP, CA) and nuclear diameter, nuclear perimeter and nuclear area (ND, NP, NA) and cytoplasmic to nuclear ratio in the exfoliated cells of various subtypes of oral lichen planus (OLP) using cytomorphometry.Materials and Methods:Oral exfoliated cells from nineteen cases of histologically proven OLP (1 atrophic, 13 reticular, 4 erosive and 1 plaque) and ten controls with healthy mucosa were taken and stained by Feulgen-Rossenback reaction and cytomorphometric analysis was performed using an image analysis software. The parameters taken into account were CD, CP, CA and ND, NP, NA. Furthermore CA/NA was calculated. The parameters were statistically analyzed using the t-test.Results:Cytomorphometric analysis of all the parameters showed no significant difference between the control group and the reticular/plaque subtypes, whereas statistically significant (P < 0.05) differences was obtained between the control group and the atrophic/erosive subtypes group when compared using t-test.Conclusions:The cytomorphometric analysis of OLP shows that erosive/atrophic subtypes of OLP are at more risk and exfoliative cytology and cytomorphometry can be used as a tool to assess the malignant changes.

Histopathological analysis of apoptotic cell count and its role in oral lichen planus.

Aim of the Study:To identify and count the number of apoptotic cells in oral lichen planus (OLP) and correlate with the degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration of OLP.Materials and Methods:The study comprised 40 diagnosed cases of OLP. Sections were stained with hematoxylin and eosin to identify and count the number of apoptotic cells. Measurement of other histopathological parameter of OLP such as degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration was done by using stage micrometer and eyepiece graticule. Statistical analysis was done to understand the correlation between apoptotic cells and histopathological features of OLP.Result:The result showed that the number of apoptotic cells increased, with an increase in thickness of lymphocytic infiltration and degree of keratinization, but there was a decrease in the epithelial thickness.Conclusion:Further immunological and molecular studies are required for a stronger evidence in correlating apoptotic cell and histological parameters of OLP.

Evaluation of ploidy status using DNA-image cytometry of exfoliated mucosal cells in oral lichen planus

Background:Oral lichen planus (OLP) is one of the potentially malignant disorders (PMDs) with a malignancy rate of 0.2-2%. Aneuploidy is considered to be one of the important markers for malignant transformation and DNA-image cytometry (DIC) has been successfully employed in oral mucosal PMDs and also in tumors of the cervix, lung and biliary tract.Aims:In this study, we intend to assess the ploidy status of exfoliated cells in OLP using DIC.Materials and Methods:Exfoliated cells from 48 patients with different subtypes of OLP (reticular, plaque type, erosive and atrophic) and 10 controls were stained using Feulgen reaction and assessed for integrated optical density using image analysis software and the ploidy status was assessed.Results:All the patients in the control group and most of the patients (93.5%) who had reticular or plaque type of OLP (29 out of 31) exhibited diploid nuclei in the smears, whereas 11 patients who had erosive or atrophic types of OLP showed aneuploid nuclei.Conclusions:The patients with erosive or atrophic types of OLP are at more risk and assessment of ploidy status by exfoliative cytology can be used as an adjuvant for diagnosis.

Histomorphometric analysis of nuclear and cellular volumetric alterations in oral lichen planus, lichenoid lesions and normal oral mucosa using image analysis software

Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. A retrospective study was done on 25 histologically diagnosed cases each of oral lichen planus, oral lichenoid lesions, and normal oral mucosa. Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Analysis of variance test (ANOVA) and Tukey's post-hoc test. The basal cells of oral lichen planus showed a significant increase in the mean nuclear and cellular areas, and in nuclear volume; there was a significant decrease in the nuclear-cytoplasmic ratio as compared to normal mucosa. The suprabasal cells showed a significant increase in nuclear and cellular areas, nuclear diameter, and nuclear and cellular volumes as compared to normal mucosa. The basal cells of oral lichenoid lesions showed significant difference in the mean cellular area and the mean nuclear-cytoplasmic ratio as compared to normal mucosa, whereas the suprabasal cells differed significantly from normal mucosa in the mean nuclear area and the nuclear and cellular volumes. Morphometry can differentiate lesions of oral lichen planus and oral lichenoid lesions from normal oral mucosa. Thus, morphometry may serve to discriminate between normal and premalignant lichen planus and lichenoid lesions. These lesions might have a high risk for malignant transformation and may behave in a similar manner with respect to malignant transformation.