Comparative histomorphometric study of intraepithelial papillary capillaries on leukoplakia with/without different dysplastic grading and squamous cell carcinoma of the oral mucosa

Purpose

Tumor growth is closely related to the development of an intrinsic vascular network. However, microvascular appearance was not regarding highly to pathological diagnosis, though clinical applicability of endoscopic narrow-bad imaging (NBI) is developed in the oral cavity. To analyze changes of intraepithelial papillary capillary loop (IPCLs) patterns as the utility for pathological diagnosis, comparative histomorphometric analysis of IPCLs among squamous cell hyperplasia, leukoplakia with low- or high-grade dysplasia, and oral squamous cell carcinoma (OSCC) had performed.

Methods

Subjects were 40 clinically hyperkeratosis, histologically consisted 5 groups; each 10 of squamous cell hyperplasia, low- or high-grade dysplasia, OSCC and normal mucosae. Sections with smooth muscle actin and CD34 immunoreactivities were used to examine comparative histomorphometric analysis on the basis of IPCL irregularities. The area, shortest diameter, proximity to the basement membrane and circularity were measured using Win Roof image analysis software. Statistical analyses were done by Kruskal–Wallis and Steel–Dwass tests. Values of p < 0.05 were considered significant.

Results

Larger vessel diameter/areas, more extension and smaller circularity with dysplastic grading, and OSCC showed the most prominent of them. In short, the changes in vessels of IPCLs in high-grade dysplasia and OSCC involve two factors: increased vessel diameter and prolongation of IPCLs toward the surface.

Conclusions

The microvascular irregularity and proliferation composed by IPCLs and IPCL like abnormal capillaries were observed pathologically in squamous epithelial lesions of the oral cavity. The change of IPCLs patterns can be of help in detecting for high-grade dysplasia or OSCC.