Microscopic features of chronic cheilitis

Aim – to evaluate morphological changes of the lip mucosa in chronic cheilitis: the condition of the epithelium, the microcirculation and the inflammatory infiltration of the intrinsic lamina of the mucosa. Material and methods. A retrospective analysis was performed of medical records, biopsy specimens and archive histological material after lip resection in patients with the diagnosis of chronic cheilitis (Tver Regional Clinical Oncological Dispensary). The sample consisted of 46 patients aged 34–72 years (19 women and 27 men). After the microscopic examination, two groups have been formed: Group A, instances of chronic inflammation of the lip without signs of epithelial dysplasia (n=24), Group B, instances with low- and high-grade dysplasia in the squamous epithelium (n=22). Changes in the epithelium, severity of hyperplasia, stratification, degree of epithelial cells maturation, karyopycnotic index, and character of inflammatory infiltrate and vascularization of intrinsic lamina of the mucosa were evaluated. Microscopic examination was performed using an Olympus CX-41 light microscope with a digital camera. Specialized software suite Video Test-Morphology 5.2 was used to study 10 fields of view of the microscope (×40 lens magnification, ×10 eyepiece) in every specimen: diameter, number of blood vessels and stromal and angiomatous components ratio measured per 1 mm2. The data was statistically processed using SPSS 22.0 suite. Results. Elderly men predominated in both groups. A comparative analysis of changes in the squamous epithelium, inflammatory reaction, and the nature of vascularization of the proper mucosa plate was performed. According to the results of morphometry, it was found that in patients of Group B the number of vessels per unit area was significantly higher than in Group A. Microscopic features of reactive changes in the epithelium and proper plate of the mucous membrane of the red border of the lips predisposing to malignant transformation were found. In chronic cheilitis with epithelial dysplasia, an uneven arrangement of vascular loops with alternating sections of hypovascularized stroma and foci of increased vascularization of the proper mucosa plate due to the accumulation of small capillaries was noted, which can be recommended as a morphological sign of an unfavorable prognosis of the inflammatory process of the red lip rim. Conclusion. In the differential diagnosis of lip diseases, pathologists should note the nature and severity of microcirculatory changes and inflammatory infiltration in the mucous membrane at the conclusion of the pathology study, along with the characteristics of squamous epithelium dysplasia, and clinicians should consider these morphological data when choosing treatment tactics for patients.