Actinic Cheilitis and Lip Squamous Cell Carcinoma: Clinical and, Histopathological Aspects and p53 Protein Expression

Lee, Yong Woo; Yun, Sook Jung; Lee, Jee Bum; Kim, Seong Jin; Lee, Seung Chul; Won, Young Ho

Abstract

BACKGROUND
Actinic cheilitis (AC) is the main precancerous lesion of the lip. Knowledge of prognostic and diagnostic markers can have positive impacts, although the exact transition rate from AC to lip squamous cell carcinoma (LSCC) is unknown.
OBJECTIVE
We analyzed 59 patients to investigate the relationship between clinical and histopathological features and the expression of the p53 protein in AC and LSCC.
METHODS
We retrospectively reviewed 59 patients who received biopsy for AC and LSCC between January 2005 and December 2012 and compared clinical and histopathological features of AC and LSCC.
RESULTS
The ratios of males to females for AC and LSCC were 1.3:1 and 1.7:1. The mean ages of those with AC and LSCC were 66.4 and 70.1 years. All of the lesions involved the lower lip, and the most frequently affected site was the right side of the lip in LSCC. Persistent fissures with scales and exudative ulcers were noted 90.6% and 43.7% of the AC cases, respectively. The intensity of the inflammatory infiltrate was significantly associated with the degree of epithelial dysplasia. Most LSCCs (96.2%) were immunoreactive to the p53 protein. The intensities of AC and LSCC p53 protein expression were 1.1 and 2.4. The degree of epithelial dysplasia was the only histopathological finding significantly associated with p53 protein expression.
CONCLUSION
An intense inflammatory infiltrate in AC was predictive of a microinvasive SCC. Therefore, p53 protein immunoreactivity may be an important indicator in lip carcinogenesis and the degree of epithelial dysplasia.