title: Potentially malignant and malignant lesions of the lip. Role of silver staining nucleolar organizer regions, proliferating cell nuclear antigen, p53, and c-myc in differentiation and prognosis.
abstract: The cellular changes leading to carcinoma of the lip are still not completely understood. This study was carried out on 44 malignant and potentially malignant lesions of the lower lip [30 squamous cell carcinomas (SCC), 7 actinic cheilitis, 3 leukoplakias, and 4 nodal metastases from lower lip SCC]. Silver-stained nucleolar organizer regions (AgNORs) and the immunohistochemical expression of proliferating cell nuclear antigen (PCNA), p53, and c-myc were evaluated on formalin-fixed, paraffin-embedded sections. The results indicate that the size and numbers of AgNORs and the percentage of PCNA-positive cells are sensitive parameters for discriminating between potentially malignant lesions and SCC, and for the prognostic sub-typing of lower lip SCC. Furthermore, while p53 positivity was found more frequently in high-grade carcinomas, p53-positive cellular clones were also found in some potentially malignant lesions, a finding probably related to ultraviolet-related cellular damage. These p53-positive lesions could be considered at higher risk of progression to malignancy than the p53-negative ones, although there is no evidence for this as yet. c-myc positivity was found only in some high-grade carcinomas and metastases, and appeared correlated with the later phases of lip carcinogenesis. The combined evaluation of the proliferation status, together with the changes in p53 and c-myc oncoproteins, might constitute useful markers for the prognostic evaluation of potentially malignant, as well as malignant, lesions of the lip.
authors.affiliation: Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy.
authors.forename: I
authors.initials: I
authors.lastname: de Rosa
authors.forename: S
authors.initials: S
authors.lastname: Staibano
authors.forename: L
authors.initials: L
authors.lastname: Lo Muzio
authors.forename: M
authors.initials: M
authors.lastname: Delfino
authors.forename: A
authors.initials: A
authors.lastname: Lucariello
authors.forename: A
authors.initials: A
authors.lastname: Coppola
authors.forename: G
authors.initials: G
authors.lastname: De Rosa
authors.forename: C
authors.initials: C
authors.lastname: Scully
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008048:Lip Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009697:Nucleolus Organizer Region / Q000378:metabolism*; D011230:Precancerous Conditions / Q000175:diagnosis / Q000378:metabolism*; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism*; D016271:Proto-Oncogene Proteins c-myc / Q000378:metabolism*; D016622:Silver Staining; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D018809:Proliferating Cell Nuclear Antigen; D016271:Proto-Oncogene Proteins c-myc; D016159:Tumor Suppressor Protein p53