Clinical, morphological and immunohistochemical aspects in laryngeal premalignant lesions.
OBJECTIVE: We investigated the proliferative activities in premalignant laryngeal vocal chord lesions treated by epithelial stripping in microlaryngoscopy, using immunohistochemical staining with anti-p53, anti-PCNA and anti-Ki-67 monoclonal antibody and we correlated with clinic and morphologic aspects. MATERIAL AND METHODS: The study was made on 32 patients hospitalized in Craiova ENT Clinic in 2005 presenting lesions precursor to vocal cord malignity. The lesion's aspect was observed using suspended microlaryngoscopy, a biopsy was performed and biological tests were examined from a pathological and immunohistochemical point of view, with the investigation of the following immunohistochemical markers: Ki-67, PCNA and p53. RESULTS: 13 cases (41%) presented red hypertrofic cronic laryngitis, seven cases (22%) presented white hypertrofic cronic laryngitis, and 12 cases (37%) presented papillomas with with simple, moderate, severe dysplasia and in situ carcinoma in 62.5%, 22%, 12.5% and, respectively, 3% of the cases. All the dysplasic lesions, no matter the dysplasic degree, have presented alteration of both surface eplitelium and chorion. The expression of Ki-67, PCNA and p53 was correlated with the dysplasia's degree in various proportions. CONCLUSIONS: In clinical practice, morphological grading of dysplasia is difficult to evaluate. The Ki-67 and PCNA markers were correlated with the dysplasia degree; the expression of p53 was present only in 28% cases with moderate dysplasia and in one case with in situ carcinoma.