Evaluation of immunohistochemical markers of p16 and p53 in patients with pathological diagnoses of actinic keratosis, Bowen’s disease, and seborrheic keratosis; a cross-sectional study from Alzahra hospital, Isfahan, Iran (2018-2022)

Introduction: While Bowen’s disease (BD) and actinic keratosis (AK) are premalignant conditions, seborrheic keratosis (SK) is a benign lesion; therefore, the differentiation of these processes is of clinical importance. Objectives: This study aimed to assess the P16 and P53 markers expression in patients with pathological diagnoses of AK, BD, and SK. Materials and Methods: This cross-sectional study included all patients with the final pathological diagnosis of AK, SK, and BD between 2018 and 2022 in Al-Zahra hospital, Isfahan, Iran. Immunohistochemical staining using the EnVision method was done for all samples. The positive results of the P16 marker were interpreted as the block staining of the nucleus and cytoplasm, and in the case of the P53 marker, the positive results were interpreted as the block staining of the nucleus. Finally, we investigated and compared the expression pattern of P53 and P16 markers in three groups of BDs, SK, and AK. Results: The expression patterns of p16 and p53 varied notably among patients with AK, SK, and BD. In cases of AK and SK, p16 predominantly exhibited null or mosaic patterns, while BD was characterized by a block pattern. For p53, both AK and BD were more likely to display null or strong patterns, whereas SK was more frequently associated with a mosaic pattern. The diagnostic value of these markers indicated that p53 and p16 patterns could effectively assist in distinguishing BD from SK and AK. Conclusion: The distinct expression patterns of p16 and p53 in AK, SK, and BD underscore their potential as valuable diagnostic biomarkers. The differences in p16 and p53 patterns can aid in accurately differentiating between benign and precancerous lesions, supporting their incorporation into diagnostic protocols to improve patient management and treatment outcomes.