gms | German Medical Science

81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

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Chromosomal instability predicts the progression of premalignant oral lesions

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  • Rinske M.P.T. Hamers - Maastricht University Medical Centre, Maastricht, The Netherlands
  • Thijs M.A.W. Merkx - Department of Oral and Maxillofacial Surgery, St Radboud University Medical Center Nijmegen, The Netherlands
  • Bernd Kremer - Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University, Maastricht, The Netherlands
  • Ernst-Jan M. Speel - Department of Molecular Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
  • Theke J.H. Siebers - Department of Oral and Maxillofacial Surgery, St Radboud University Medical Center, Nijmegen, The Netherlands
  • Annick Haesevoets - Department of Molecular Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
  • Iris R. Zwijnenberg - Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University, Maastricht, The Netherlands
  • Adri C. Voogd - Department of Epidemiology, Maastricht University Medical Centre, Maastricht, The Netherlands
  • Pieter J. Slootweg - Department of Pathology, St Radboud University Medical Centre, Nijmegen, The Netherlands
  • Frans C.S. Ramaekers - Department of Molecular Cell Biology, Maastricht University Medical Centre, Maastricht, The Netherlands

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hnod302

doi: 10.3205/10hnod302, urn:nbn:de:0183-10hnod3029

Published: April 22, 2010

© 2010 Hamers et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: A major dilemma in the management of patients with precursor lesions of the oral mucosa lies in deciding which lesions will progress into carcinoma. The aim of this study was to evaluate the value of chromosomal instability (CIN) detected by fluorescence in situ hybridization (FISH) for the identification of oral premalignant lesions at risk for progression.

Materials and methods: We examined a series of premalignant oral mucosa lesions of 106 patients by means of FISH on paraffin-embedded tissue sections using chromosome 1 and 7-specific centromere probes. CIN was indicated by the presence of chromosome imbalances and/or polyploidization. Results were correlated with histopathological data as well as with clinical follow-up data.

Results: The 5-year progression-free survival rate was 83%. Outcome of routine histopathology did only predict malignant progression when comparing severe dysplasia with lower stage precursor lesions (hyperplasia, mild en moderate dysplasia) (p<0.001). CIN was detected in all different subgroups of histopathological differentiation. Moreover, the percentage of precursor lesions harboring CIN increased with progressing histopathological stage. CIN was significantly associated with a lower progression-free survival as compared with lesions without CIN (p<0.001).

Conclusion: The tumorigenesis of the oral mucosa is associated with the development of CIN, which can reliably identify lesions at risk for malignant progression.

Key words: premalignant oral lesions, chromosomal instability, FISH

Supported by: The Dutch Cancer Society