title: Clinicopathological features and immunohistochemical expression of p53, Ki-67, Mcm-2 and Mcm-5 in proliferative verrucous leukoplakia.
abstract: BACKGROUND
  Proliferative verrucous leukoplakia (PVL) is a distinct and aggressive type of oral leukoplakia which affects elderly women without risk behavior and presents high rates of malignant transformation. The objective of the present study was to evaluate the clinicopathological characteristics and the distribution of cell proliferation markers, aiming to elucidate the distinct biological behavior of the PVL.
  
  
  METHODS
  Clinical and microscopical features of 12 patients with PVL were reviewed. Immunohistochemical analysis for p53, Ki-67, Mcm-2 and Mcm-5 were performed and the data were correlated.
  
  
  RESULTS
  All patients were women, above 50 years of age, 91.7% were non-smoker and 100% were non-habitual drinker. Alveolar ridge (66.6%), tongue (50%) and buccal mucosa (41.6%) were the most affected sites. Four patients developed squamous cell carcinoma (SCC). The immunohistochemical findings showed higher positivity for p53, Ki-67, Mcm-2 and Mcm-5 in SCCs. However, some patients with mild or moderate dysplasia, specially the patients who developed SCC, presented high expression of Mcm-2 and Mcm-5.
  
  
  CONCLUSIONS
  High immunoexpression of Mcm-2 and Mcm-5 in mild and moderate dysplasia could be helpful to predict the malignant transformation of PVL.
authors.affiliation: Department of Oral Diagnosis, Oral Semiology and Pathology Section, Piracicaba Dental School, State University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Adriele Ferreira
authors.initials: AF
authors.lastname: Gouvêa
authors.forename: Pablo Agustin
authors.initials: PA
authors.lastname: Vargas
authors.forename: Ricardo D
authors.initials: RD
authors.lastname: Coletta
authors.forename: Jacks
authors.initials: J
authors.lastname: Jorge
authors.forename: Márcio Ajudarte
authors.initials: MA
authors.lastname: Lopes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D018797:Cell Cycle Proteins / Q000096:biosynthesis; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D019394:Ki-67 Antigen / Q000096:biosynthesis; D007972:Leukoplakia, Oral / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D064111:Minichromosome Maintenance Complex Component 2; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology; D009687:Nuclear Proteins / Q000096:biosynthesis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D014860:Warts / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; D019394:Ki-67 Antigen; C489423:MCM5 protein, human; D009687:Nuclear Proteins; D016159:Tumor Suppressor Protein p53; C084859:MCM2 protein, human; D064111:Minichromosome Maintenance Complex Component 2