Alterations in the expression of DNA damage response-related molecules in potentially preneoplastic oral epithelial lesions

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Jun;125(6):637-649. doi: 10.1016/j.oooo.2018.03.006. Epub 2018 Mar 22.


Objectives: The aim of this study was to evaluate the expression levels of DNA damage response (DDR) markers in potentially preneoplastic oral epithelial lesions (PPOELs).

Study design: Immunohistochemical expression of DDR markers (γΗ2 ΑΧ, pChk2, 53 BP1, p53, and phosphorylated at Ser 15 p53) was assessed in 41 oral leukoplakias, ranging from hyperplasia (H) to dysplasia (D) and in comparison with oral squamous cell carcinoma (OSCC) and normal mucosa (NM). Statistical and receiver operating characteristic curve analysis were performed.

Results: γH2 AX immunoexpression demonstrated a gradual increase and upper layer extension from NM to H to higher D degrees to OSCC. pChk2 expression was minimal in NM, relatively low in PPOELs, with an increasing tendency from H to D, and higher in OSCC. 53 BP1 demonstrated higher levels in OSCC than in NM, whereas its expression in PPOELs was heterogeneous, gradually increasing according to D. p53 demonstrated progressively higher levels and upper layer extension from H to D to OSCC. Phosphorylated p53 was absent in NM and relatively low in PPOELs and OSCC.

Conclusions: DDR markers' expression is variable in PPOELs, showing a tendency to increase along with dysplasia. Activated DDR mechanisms may play an important protective role at early stages of oral carcinogenesis, but probably suffer progressive deregulation, eventually failing to suppress malignant transformation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / analysis*
  • Biopsy
  • Carcinoma, Squamous Cell / pathology*
  • Cell Transformation, Neoplastic / pathology*
  • DNA Damage*
  • Erythroplasia / pathology*
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Leukoplakia, Oral / pathology*
  • Male
  • Middle Aged
  • Mouth Neoplasms / pathology*
  • Precancerous Conditions / pathology*


  • Biomarkers