Avaliação clínica, histopatológica e imuno-histoquímica de 48 casos de queilite actínica

Abstract

Actinic cheilits (AC) is a premalignant lesion of the lip. In general, patients with actinic cheilitis present with no symptoms and clinical signs do not reflect the hystopathological severity of the lesion, allowing its evolution to invasive cancer. Prognostic indicators for evolution of such lesions have been investigated by different groups, including the detection of alterations in the TP53 gene. A series of 48 patients with actinic cheilitis is evaluated in this study. Clinical signs, histopathological features and imunohistochemistry detection of the p53 protein were evaluated in this group. All the patients were caucasian and 44% had a previous history of non-melanoma skin cancer in another site of the body. The most frequent clinical signs observed in the patients included loss of lip vermilion (75%), pelling of the lip (71%) and atrophy (67%). Eighty-five per cent of the patients did not present, on the first consultation, specific complaints related to actinic cheilitis. Histopathological analysis described dyskeratosis in 95% of the samples, epithelial hyperplasia in 85% and dysplasia in 57% of the cases. munodetection of p53 on the suprabasal layer was diffuse in 8 patients. Among hem, 12% of the samples showed dyskeratosis, 87% hyperplasia and 100% presented epithelium dysplasia. The diffuse imunodetection of the p53 protein on he suprabasal layer correlated positively with the presence of epithelial dysplasia (p many 0,005). According to different reports, dysplasia is the most significant prognostic factor to the evolution of actinic cheilitis to squamous cell carcinoma of he lip. We here suggest that the imunodetection of p53 on the suprabasal layer of actinic cheilitis samples might also represent an important prognostic factor to such premalignant lesions.