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The Korean Journal of Pathology 1996;30(4): 318-327.
Clinicopathological Analysis of Laryngeal Leukoplakia: Clinical Follow-up and Immunohistochemical Expression of p53 and PCNA.
Yang Soon Park, Sang Yoon Park, Soon Ae Oak, Gyung Yup Gong, Joo Ryung Huh, Eun Sil Yu, In Chul Lee, Ghee Young Choe
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine.
2Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine.
3Department of Pathology, Seoul City Boramae Hospital, Seoul National University College of Medicine, 110-744 Seoul, Korea.
ABSTRACT
Laryngeal leukoplakia is seen in a number of pathologic settings such as keratosis without atypia(KWOA), keratosis with atypia(KWA), squamous cell carcinoma in situ(CIS) and invasive squamous cell carcinoma, and it continues to be a confusing and controversial topic for both otolaryngologist and pathologist. This is largely due to the use of ambiguous and inconsistent terminology, the lack of unanimous agreement on the definition of these terms, failure of the clinician to obtain a representative biopsy, and the subjectivity of the pathologist interpreting the biopsy. To evaluate the applicability of the expression pattern of p53 and PCNA in borderline cases of histopathologic classification, we performed a histopathologic analysis of leukoplakia to includ clinical follow-up, correlation of disease progression and degree of atypia, and expression of p53 and PCNA according to the degree of atypia. Histologically, laryngeal leukoplakia included seven cases of KWOA, fourteen cases of KWA (mild-2, moderate-8, severe-4), three cases of CIS, and one case of invasive squamous cell carcinoma. Keratosis with atypia, a moderate degree or more, showed a strong tendency to progress to invasive carcinoma(p<0.05). The degree of p53 and PCNA expression correlated with the degree of atypia(p<0.05). p53-positive cases at the initial biopsy clearly tended to recur and develop into invasive carcinoma(p<0.01).
Key Words: Laryngeal leukoplakia; Keratosis; p53; PCNA