Evaluation of proliferative potential in oral lichen planus and oral lichenoid lesions using immunohistochemical expression of p53 and Ki67.

A small proportion of cases diagnosed as oral lichen planus (OLP) and oral lichenoid lesions (OLL) can undergo malignant transformation. Some authors, however, stand that only dysplastic lichenoid lesions, not true OLP, have the potential to progress to oral squamous cell carcinoma (OSCC). The histologic diagnosis is a subjective resource and is not always accurate in differentiating OLP from OLL. Thus, this study attempted to evaluate the malignant potential of lesions diagnosed as OLP and as OLL without dysplasia. The Streptavidin-biotin method of immunohistochemistry was used for the staining with p53 and Ki67 in 22 cases of OLP and 27 cases diagnosed as OLL. Ki67 immunoexpression was not statistically different between OLP and OLL (p = 0.353), but, p53 staining showed a significant contrast (p = 0.036). A higher average of staining was detected in the group of OLP. The study showed that apparently a diagnosis of OLP or OLL makes no difference for the patient regarding malignant transformation, although in OLP p53 showed a higher index of expression, probably related to the intensity of inflammatory infiltrate.