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CC BY-NC-ND 4.0 · South Asian J Cancer 2025; 14(04): 752-759
DOI: 10.1055/s-0044-1786810
Original Research Article
Laboratory Section

Exploring the Role of EZH2 and BCL2 in Demarcating Oral Verrucous Hyperplasia and Verrucous Carcinoma

Authors

  • Shreya Chatterjee

    1   Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India

  • Anju Devi

    1   Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India

  • Mala Kamboj

    1   Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India

  • Anjali Narwal

    1   Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
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Abstract

Introduction

Oral verrucous hyperplasia (OVH) and verrucous carcinoma (OVC) are precursors of oral squamous cell carcinoma exhibiting overlapping histopathological picture which warrants distinction. EZH2 is an epigenetic marker possessing multifaceted function in cellular proliferation, migration, and malignant transformation, whereas BCL2 is an integral part of the antiapoptotic mechanism regulating cellular homeostasis.

Aim

The aim was to distinguish OVH and OVC by analysis of immunohistochemical expression of EZH2 and BCL2.

Material and Methods

The study sample consisted of 79 formalin-fixed paraffin-embedded tissue sections of normal oral mucosa (10), OVH (10), oral OVC (27), and oral squamous cell carcinoma (32). Immunohistochemical analysis of EZH2 and BCL2 was done and labeling indices were calculated. Additionally, six histopathological parameters were assessed in OVH and OVC. Statistical analysis was done using Kruskal–Wallis test, Tukey honest significant difference test, and Spearman's correlation. Receiver operating characteristic curve was plotted and sensitivity, specificity, and cutoff score of each marker were calculated.

Result and Discussion

Labeling indices of EZH2 and BCL2 depicted a gradual incline from normal mucosa to oral squamous cell carcinoma. Significant difference of EZH2 and nonsignificant difference in BCL2 expression between OVH and OVC were noted. Out of the six histopathological parameters, keratin plugging, juxtaepithelial lymphocytic response, and frank endophytic growth yielded a significant difference. EZH2 serves as a superior marker than BCL2 to differentiate OVH and OVC. Juxtaepithelial lymphocytic response can also serve as a histopathological parameter in distinguishing OVH and OVC.

Keywords

verrucous hyperplasia - verrucous carcinoma - BCL2 - EZH2 - oral squamous cell carcinoma - distinguish - proliferation - apoptosis

Supplementary Material



Publication History

Received: 17 July 2023

Accepted: 02 April 2024

Article published online:
07 May 2024

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