Differential diagnosis of tumors and borderline neoplastic processes of the lower lip vermilion border using molecular genetic studies

The difficulties in morphological verification of borderline neoplasia and early-stage cancer of the lower lip vermilion using classical histological staining necessitate the research and development of new diagnostic methods. The aim of the study was to improve the differential diagnostics between microinvasive cancer of the lower lip vermilion and precancerous actinic cheilitis by comparing the immunohistochemical staining intensity for Ki-67, p53, p16, and E-cadherin in biopsy specimens of the studied material.
Materials and methods. The article presents clinical cases of differential diagnostics between primary cheilitis and cancer of the lower lip vermilion using immunohistochemical markers Ki-67, p53, p16, and E-cadherin. At primary biopsy, morphological verification does not always allow to establish a diagnosis, requiring repeated histological examination and delaying the start of anticancer treatment for the patient.
Results. We found no significant difference in the number of proliferating cells in biopsy material from the patients with cheilitis and early microinvasive cancer based on the Ki-67 cell proliferation marker assessment. An increase in the expression of the apoptosis protein p53 by 15% and a decrease in the intercellular interaction marker E-cadherin by 21% were found in biopsy samples of the vermilion of the lower lip in early-stage cancer compared to primary cheilitis.
Conclusion. The use of IHC in diagnostics allowed for timely treatment of the pathological process, which reduced the duration of specialized treatment and lowered the risk of disease progression and metastasis. However, the capabilities of this method in clinical diagnosis should not be overestimated. Immunohistochemistry is an additional investigation method, and its results should be interpreted in the context of other examination data, including clinical data.
Keywords: cancer of the lower lip vermilion, morphological verification of malignant process, primary cheilitis, Ki- 67, p53, p16, E-cadherin, immunohistochemical study
Conflict of interest. The authors declare that there is no conflict of interest.
Funding. The study has not received any funding.