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Volume 19, Number 2, June 2007

Evaluation of Epithelial Dysplasia at the Surgical Margins in Patients with Early Tongue Carcinoma — Immunohistochemical Study of Recurrence of Epithelial Dysplasia

Yuichiro Okazaki,1 Kazumichi Sato,2 Atsushi Takada,2 Shigeki Morisaki,2 Yutaka Watanabe,2 Yasuhiro Ozawa,2 Mitsuaki Morimoto,2 Morio Tonogi,2 Yoichi Tanaka,3 Gen-yuki Yamane1,2
1Oral Cancer Center and 2Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, and 3Division of Surgical Pathology, Clinical Laboratory, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan

Abstract
Objective: The diagnosis of epithelial dysplasia at the surgical margins in oral cancer plays an important role in its prognosis and requires careful evaluation. Epithelial dysplasia is usually asymptomatic, but often associated with recurrence and malignant transformation.
Patients and Methods: The patients included 9 men and 5 women (mean age, 54.6 years; range, 31 to 76 years) with early tongue carcinoma and tumour-cell-“free” surgical margins. Immunohisto-chemical analysis of p53 and Ki-67 expression was performed in order to evaluate epithelial dysplasia and pathological changes.
Results: None of the patients had cancer recurrence, but 2 showed recurrence of epithelial dysplasia. The re-section margins at initial surgery and at recurrence were positive for p53 and Ki-67 in both these patients.
Conclusion: Epithelial dysplasia, with positive staining for p53 and Ki-67, has the potential for morphological changes, with possible recurrence of epithelial dysplasia or malignant transformation. Such patients will require careful follow-up for local recurrence. Examination of surgical margins for these markers is useful for the early detection of pathological changes.


Key words: Ki-67 antigen, Precancerous conditions, Recurrence, Tongue neoplasms, Tumor suppressor protein p53

Asian J Oral Maxillofac Surg. 2007;19:89-95.
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