Comparative study of the expression of p53, Ki67, E-cadherin and MMP-1 in verrucous hyperplasia and verrucous carcinoma of the oral cavity.

Context: Oral verrucous carcinoma (OVC) and oral verrucous hyperplasia (OVH) may be clinically and histologically similar. Problems separating these lesions are compounded by poorly oriented tissue sections and biopsies failing to demonstrate lesional margins.

Objective: To distinguish OVC from OVH utilizing an immunohistochemical panel (p53, matrix metalloproteinase-1, E-cadherin, Ki67) shown to be useful in differentiating pseudoepitheliomatous hyperplasia from oral squamous cell carcinoma of the head and neck.

Materials: Twenty-eight cases of OVH and thirty-two cases of OVC studied. Diagnoses were confirmed by two pathologists. Formalin-fixed, paraffin-embedded archival material was used for immunohistochemistry (avidin-biotin immunoperoxidase technique).

Results: More diffuse nuclear staining of p53 and Ki67 was detected in the OVC cases compared to the OVH cases (P < 0.001). There was statistically significant increased staining within adjacent stromal cells for matrix metalloproteinase-1 (P < .05) in the OVC cases. E-cadherin demonstrated diffuse membranous staining in both groups.

Conclusion: Ki67, p53, and MMP-1 demonstrated significant staining trends. Although a properly oriented hematoxylin-eosin-stained section including normal marginal tissue is considered to be the gold standard for differentiation of OVH and OVC, this immunohistochemistry panel may serve as a useful diagnostic adjunct in difficult cases.