Oral Liken Planus ve Skuamöz Hücreli Karsinom Olgularında Langerhans Hücre Yoğunluğunun Değerlendirilmesi

Year 2020, , 481 - 485, 20.10.2020

Pelin Yıldız , Fatma Sönmez Zeynep Tosuner Emre Aytuğar

https://doi.org/10.18521/ktd.737093

Abstract

Amaç: Oral mukoza pek çok etken tarafından hasara uğratılabilmektedir. Oral patolojilerin hücre aracılı immünite ile ilişki olabileceği öne sürülmüş ve bu konuda çok çeşitli araştırmalar yapılmıştır. Dendritik hücreler, adaptif hücresel cevabı başlatan antijen sunucu hücrelerdir. Bu grubun önemli bir üyesi olan Langerhans hücreleri(LH), tüm stratifiye epitellerde özellikle de skuamöz epitelin orta ve üst kısmında yerleşir. Oral liken planus(OLP) sık görülen, etyolojisi net bilinmeyen kronik mukokutanöz inflamatuar bir hastalıktır. Oral kavitede en sık rastlanan malignite oral skuamöz hücreli karsinomdur(OSHK). Çalışmamızda mukozal savunmada önemli rolü olan Langerhans hücrelerinin OLP ve OSHK’da dağılımını inceleyerek lokal immün cevaptaki rolü hakkında fikir sahibi olmayı amaçladık

Yöntem: 2013-2016 yılları arasında Diş Hekimliği Fakültesi tarafından gönderilen, 36 adet OLP, 28 adet OSHK ve kontrol grubu olarak 10 adet normal mukoza olmak üzere toplam 74 hasta retrospektif olarak yeniden değerlendirilmiş, uygun bloklar seçilerek immunhistokimyasal olarak Langerin antikoru uygulanmıştır. Her olguda 1mm2’lik alanlarda bazal ve suprabazal yerleşimli LH’leri sayılmıştır.

Bulgular: Çalışmamızda OLP olgularında kadın(%60),OSHK olgularında erkek hakimiyeti(%58) izlendi. Yaş dağılımı OLP’larda 53±12 iken OSHK’da 61±21 idi. OLP hastaların %86’sında yanak mukozasında yerleşimli iken OSHK olgularında bu oran sadece %11’di. Langerhans hücre yoğunluğu kontrol grubunda 87(57-105), OLP’da 104(84-143), OSHK’da 82(48-128)’du.

Sonuç: Çalışmamızda LH’lerinde sayısal olarak OLP’lerde kontrol ve OSHK olgularına göre istatiksel olarak anlamlı artış izlenmiştir. Literatürde bu durumlarla ilgili çeşitli farklı sonuçlara rastlamak mümkündür. Langerhans hücrelerinin bu hastalıklardaki yoğunluğunun belirlenmesi, hastalığın patogenezi ve tedavi seçeneklerinin geliştirilebilmesi açısından yol gösterici olabilir.

Keywords

Oral, Skuamoz hücreli karsinom, Liken planus, Langerhans hücresi

Evaluation of Langerhans Cell Density in Oral Lichen Planus and Squamous Cell Carcinoma

Abstract

Objective: Oral mucosa exposed to many external factors. It has been suggested that oral pathologies may be related to cell-mediated immunity. Dendritic cells are antigen presenting cells that initiate adaptive cellular response. Langerhans cells(LCs), an important member of this group. Oral lichen planus(OLP) is a common chronic mucocutaneous inflammatory disease of unknown etiology. The most common malignancy in the oral cavity is oral squamous cell carcinoma(OSCC). In this study, we aimed to understand the role of LCs in OLP and OSCC which has an important role in mucosal defense.

Method:A total of 74 biopsies taken from Dentistry Department between 2013-2016 were included into the study. The 74 cases;36 OLP, 28 OSCC and 10 normal mucosa as a control group were retrospectively re-evaluated. After selecting appropriate blocks, to evaluate Langerhans cells Langerin was applied immunohistochemically. Basal and suprabasal located immune positive Langerhans cells were counted in 1mm2 areas in each case.

Results:In our study, female(60%) predominancy in OLPs, male predominancy(58%) in OSCCs were reported. Age distribution mean was 53±12 in OLPs and 61±21 in OSCCs. OLP was localized in the buccal mucosa in 86% of patients, whereas this rate was only 11%in OSCC cases. LCs density was 87(57-105) in the control group, 104(84-143) in OLPs, and 82(48-128) in OSCCs.

Conclusion:LC density was found significantly higher in OLPs compared to control group and OSCCs.In literature, variable results were published. Determining the density of Langerhans cells in these diseases can be a guide in terms of the pathogenesis of the disease and the improvement of treatment options.

Keywords

Oral, skuamöz hücreli karsinom, Lichen planus, Langerhans cell

References

• 1. Idris A, Hasnain SZ, Huat LZ, et al.: Human diseases, immunity and the oral microbiota—Insights gained from metagenomic studies. Oral Science Int. 2017; 14(2): 27–32. 2. Farthing PM, Speight PM, Problems and pitfalls in oral mucosal pathology. Current Diagnostic Pathology (2006) 12, 66–74. 3. Maloth AK, Dorankula SP, Pasupula AP, Thokala MR, Muddana K, Ramavath R. A Comparative Immunohistochemical Analysis of Langerhans Cells in Oral Mucosa, Oral Lichen Planus and Oral Squamous Cell Carcinoma J Clin Diagn Res. 2015 Jul;9(7):ZC76-9 4. Narwal A, Saxena SA. comparision of langerhans cell numbers in tobacco associated leukoplakia and oral squamous cell carcinoma. J Oral Med Sci. 2011;10(3):125-31. 5. Upadhyay J, Upadhyay RB, Agrawal P, Jaitley S, Shekhar R. Langerhans Cells and Their Role in Oral Mucosal Diseases N Am J Med Sci. 2013 Sep; 5(9): 505–514. 6. Jivan V, Meer S.Quantification of oral palatine Langerhans cells in HIV/AIDS associated oral Kaposi sarcoma with and without oral candidiasis. 7. Devi M, Saraswathi T R, Ranganathan K, Vijayalakshmi D, Sreeja C, Fathima S S. Langerhans cells in lichen planus and lichenoid mucositis an immunohistochemical study.J PharmBioall Sci 2014;6:146149 8. Gooty JR, Kannam D, Guntakala VR, Palaparthi R. Distribution of dendritic cells and langerhans cells in peri-implant mucosa. Contemp Clin Dent 2018;9:548-53. 9. Shirasuna, K. (2014), Oral lichen planus: Malignant potential and diagnosis. Oral Science International, 11: 1-7. 10. Carbone M, Arduino PG, Carrozzo M, Gandolfo S, Argiolas MR,Bertolusso G, et al. Course of oral lichen planus: a retrospective Study of 808 northern Italian patients.Oral Sis. 2009; 15: 235-243 11. Omar EA The Outline of Prognosis and New Advances in Diagnosis ofOral Squamous Cell Carcinoma (OSCC): Review of the Literature Journal of Oral Oncology Volume 2013, Article ID 519312, 13 pages 12. Pereira KM, Soares RC, Oliveira MC, Pinto LP, Costa Ade L. Immunohistochemical staining of Langerhans cells in HPV-positive and HPV-negative cases of oral squamous cells carcinoma.J Appl Oral Sci. 2011 Aug;19(4):378-83. 13. Upadhyay J, Rao NN, Upadhyay RB, A comparative analysis of langerhans cell in oral epithelial dysplasia and oral squamous cell carcinoma using antibody CD-1a Journal of cancer research and therapeutics October 2012;8(4):591-7. 14. Schroeder H, Thelade J. Electron microscopy of normal human gingival epithelium. J Perodont Res.1986;21:640–52. 15. Farhi D, Dupin N. Pathophysiology etiologic factors, and clinical managementof oral lichen planus. Part I. Facts and controversies. Clin Dermatol 2010;28:100–8. 16. Gumru B. A retrospective study of 370 patients with oral lichen planus in Turkey. Med Oral Patol Oral Cir Bucal 2013;18:e427–32. 17. Kumar T, Veeravarmal V, Nirmal RM, Amsaveni R, Nassar MHM, Kesavan G. Expression of Cluster of Differentiation 1a-Positive Langerhans Cells in Oral Lichen Planus. Indian J Dermatol. 2019 Jan-Feb;64(1):41-46. 18. Jaitley S, Saraswathi TR. Pathophysiology of langerhans cells. journal of oral andmaxillofacial pathology. 2012;16(2):239-44. 19. Mizukawa N, Sugiyama K, Yamachika E, Ueno T, Mishima K, Sugahara T.Presence of defensin in epithelial Langerhans cells adjacent to oral carcinomas and precancerous lesions. Anticancer Res. 1999;19(4B):2969-71. 20. Upadyay RB, Upadyay J, Rao NN, Agarwal P. Role of langerhans cells in oral squamous cell carcinoma. The Chinese-German Journal of Clinical Oncology.2011;10(10):606-11. 21. Ali A, Rautemaa R, Hietanen J, Beklen A, Konttinen Y. A possible CD1a Langerhans cell mast cell interaction in Chronic Hyperplastic Candidosis. J Oral Pathol Med. 2007;36:329–36. 22. Pitigala-Arachchi A, Crane IJ, Scully C, Prime SS. Epithelial dendriticcells in pathological human oral tissues. J Oral Pathol Med1989;18:11–16.