ALDH, SOX and CD147 Εxpression in Oral Lichen Planus Compared to Oral Squamous Cell Carcinoma Epithelium: An Immunohistochemical Study

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INTRODUCTION: Oral potential malignant diseases (OPMDs) are transformed into oral squamous cell carcinoma (OSCC) by cancer stem cells (CSCs), which also start the process of carcinogenesis de novo. Our study's objective was to examine the expression of ALDH, SOX, and CD147 in OSCCs and oral lichen planus (OLP). METHODS: An immunohistochemical detection was performed in 24 OLP samples (10 reticular OLPs (ROLPs) and 14 erosive OLPs (EOLPs)) and 21 OSCC samples of all differentiation levels to track the expression profile of ALDH1/2, SOX2, and CD147. Immunohistochemistry was applied in a semiquantative fashion to finish the aforementioned process. The paraffin-embedded tissue samples were taken from biopsies conducted in the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, between 2014 and 2019, as well as from the Oral and Maxillofacial Surgery Clinic of G. Papanikolaou General Hospital, Aristotle University, and the Oral and Maxillofacial Surgery Clinic of St Luke Hospital, Thessaloniki, Greece. A scale ranging from 0 to 2 was used to assess the expressions of ALDH1/2, SOX2, and CD147 based on the proportion of positive epithelial cells. Depending on the sample size, either Fischer's exact test or Pearson chi-square test was used for the statistical analysis, with a significance threshold of p≤0.05. RESULTS: ALDH1/2 expression was statistically considerably greater in OSCC compared to EOLP (p=0.019) and ROLP (p<0.001), according to the statistical analysis. The statistical analysis of SOX2 staining revealed statistically significant greater expression in OSCC compared to ROLP (p=0.012) and EOLP compared to ROLP (p=0.024). The statistical analysis revealed that EOLP had statistically substantially higher expression of CD147 staining than ROLP (p=0.019). There were no statistically significant findings from the remaining comparisons. In conclusion, the distinctively increased expression of CD147 in EOLP as opposed to ROLP raises the possibility that erosive lichenoid lesions contain neoplastic cells with specific CSC traits. The distinctively increased expression of SOX2 in OSCC and EOLP as opposed to ROLP raises the possibility that erosive lichenoid lesions contain malignant cells with specific CSC traits. In any event, additional experimental testing in a greater number of samples is necessary for the clinical application of CSC biomarkers as prognostic variables.

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