Relationship of infiltrating intraepithelial T lymphocytes in the diagnosis of oral lichen planus versus oral epithelial dysplasia: a pilot study

Andres Flores-Hidalgo; Valerie Murrah; Yuri Fedoriw; Ricardo J Padilla

doi:10.1016/j.oooo.2019.02.004

Relationship of infiltrating intraepithelial T lymphocytes in the diagnosis of oral lichen planus versus oral epithelial dysplasia: a pilot study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Jun;127(6):e123-e135. doi: 10.1016/j.oooo.2019.02.004. Epub 2019 Feb 13.

Authors

Andres Flores-Hidalgo¹, Valerie Murrah², Yuri Fedoriw³, Ricardo J Padilla⁴

Affiliations

¹ Clinical Assistant Professor, Oral and Maxillofacial Pathology, Department of Surgical Sciences, East Carolina University, School of Dental Medicine, 1851 MacGregor Downs Rd, Greenville, NC 27834-4354, USA. Electronic address: floresan18@ecu.edu.
² Professor and Chair, Oral and Maxillofacial Pathology, Department of Diagnostic Sciences, University of North Carolina at Chapel Hill, School of Dentistry, Chapel Hill, NC, USA.
³ Associate Professor, Director of Hematopathology UNC Hospitals, Department of Pathology and Laboratory Medicine, Hematopathology Laboratory, NC Cancer Hospital C3162, Chapel Hill, NC, USA.
⁴ Kaneda Family Distinguished Associate Professor, Oral and Maxillofacial Pathology, Department of Diagnostic Sciences, University of North Carolina at Chapel Hill, School of Dentistry, 101 Manning Drive, Chapel Hill, NC, USA.

PMID: 30928328
DOI: 10.1016/j.oooo.2019.02.004

Abstract

Objective: The aim of this study was to identify the type and distribution of CD4+ and CD8+ T lymphocytes in oral mucosal specimens to potentially distinguish between underlying alterations or patterns in oral epithelial dysplasia and oral lichen planus.

Study design: This pilot study included 10 archived tissue samples that were received at the University of North Carolina Oral and Maxillofacial Pathology Laboratory and were diagnosed as oral lichen planus and moderate to severe epithelial dysplasia. Dual staining with CD4 and CD8 antibodies was carried out on each case. Slides were scanned in the Aperio ScanScope FL (Leica Biosystems, Wetzlar, Germany) and archived. Histomorphometric analysis was performed to detect inflammatory cells expressing CD4 and CD8 biomarkers in the epithelial and connective tissue regions.

Results: No differences were found in the amount and ratio of CD4+/CD8+ lymphocytes among the 3 groups analyzed; however, the intraepithelial CD8+ lymphocyte distribution was strikingly different between lichen planus and moderate to severe epithelial dysplasia.

Conclusions: The localization of CD8+ cells can be potentially useful as an adjunctive diagnostic procedure to distinguish oral epithelial dysplasia from other inflammatory entities, such as lichen planus.

MeSH terms

CD8-Positive T-Lymphocytes
Germany
Humans
Intraepithelial Lymphocytes*
Lichen Planus*
Lichen Planus, Oral*
Mouth Mucosa
Pilot Projects