Immunohistochemical study data analysis off oral mucosa in the erosive and ulcerative form of the lichen planus

The use of cytologic examination enables a comprehensive clinical diagnosis of the erosive an ulcerative form (L43.82) of the Lichen Planus in the oral mucosa (EUF LP OM) to exclude malignancy. The goal of the study consisted of evaluating the expression of the factors of antigenicity (HLA-DR), fibrosis (MMP-9, TGF-β), acute phase inflammation protein (TNF-α), inflammatory cell infiltration (CD68) by immunohistochemical study in the diagnosis of the erosive and ulcerative form of the Lichen Planus in the oral mucosa (L43.82). Materials and methods. The study involved the analysis of 14 cases of the EUF and 8 with the typical form of the Lichen Planus in the oral mucosa (OM) from whom the buccal mucosa biopsy samples have been taken for immunohistochemical analysis of antigenicity factors (HLA-DR), fibrosis (MMP-9, TGF-β), acute phase inflammation protein (TNF-α), and inflammatory cell infiltration (CD68). The density of the HLA-DR+, MMP-9+, CD68+, TGF-β cells studied has been measured in intraepithelial and subepithelial areas. Multivariate analysis of variance, as well as correlation and linear regression have been used as statistical tests. Results. In the erosive an ulcerative form of the Lichen Planus (EUF LP), the amount of HLA-DR+ antigen has been 6.2 times higher, expression of phagocytic macrophages CD68+ in the subepithelial area has been 6.6 times higher, TNF-α+ cells has been 2 times higher, the number of MMP-9+ cells has been 2.4 times higher, and of TGF-β positive cells has been 5, 7 times higher than the values of typical (reticular) form (p≤0,05); Phagocytic macrophages CD68+ have been associated with immunopathogenesis of the LP OM, indicating pro-inflammatory activity and regulatory role in the type of T cell response. Furthermore, CD68+ macrophages may be involved in the diagnosis of the LP OM. Conclusion. High levels of the factors of antigenicity (HLA-DR), fibrosis (MMP-9, TGF-β), acute phase inflammation protein (TNF-α), inflammatory cell infiltration (CD68) have been observed in the erosive and ulcerative form of the LP OM, which has become a criterion for cancer alertness.