The influence of laser surgery on the assessment of "molecular margins" in carcinomas and mucous membranes of the upper aerodigestive tract.
OBJECTIVE
A correlation has been shown between the occurrence of the p53 protein in margins of excised carcinomas and a higher incidence of recurrences. The presented study deals with thermic alterations in resection margins after laser surgery and their impact on p53 protein and LDH detection.


METHODS
Healthy mucosa of the oropharynx and carcinoma samples were excised with scalpel, CO2 laser and Nd:YAG laser. Alterations of lactate dehydrogenase (LDH) and the p53 status of the samples were determined by immunohistochemistry and molecular biologic methods.


RESULTS
Total activity of LDH was not altered by the different modes of excision. The expression of p53 could be detected in all mucosa specimen by ELISA. In laser-surgically excised tissue regularly a small zone adjacent to the cutting edge could be demonstrated where p53 could not be detected by immunohistochemistry.


CONCLUSIONS
Immunohistochemical and molecular assessment of laser surgical margins is possible despite thermic artefacts. Laser surgery therefore does not minimize the prognostic value of resection margins of carcinomas of the upper aerodigestive tract.
Folz
B J
BJ
Department of Otolaryngology, Head and Neck Surgery, Philipps University, Marburg. folz@mailer.uni-marburg.de
Lippert
B M
BM
Kuelkens
C
C
Werner
J A
JA
D014408:Biomarkers, Tumor / Q000502:physiology; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000601:surgery*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000378:metabolism / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000378:metabolism / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D010610:Pharyngeal Neoplasms / Q000378:metabolism / Q000601:surgery*; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53