Oral Liken Planus ve Skuamöz Hücreli Karsinom Olgularında Langerhans Hücre Yoğunluğunun Değerlendirilmesi

Abstract

Amaç: Oral mukoza pek çok etken tarafından hasara uğratılabilmektedir. Oral patolojilerin hücre aracılı immünite ile ilişki olabileceği öne sürülmüş ve bu konuda çok çeşitli araştırmalar yapılmıştır. Dendritik hücreler, adaptif hücresel cevabı başlatan antijen sunucu hücrelerdir. Bu grubun önemli bir üyesi olan Langerhans hücreleri(LH), tüm stratifiye epitellerde özellikle de skuamöz epitelin orta ve üst kısmında yerleşir. Oral liken planus(OLP) sık görülen, etyolojisi net bilinmeyen kronik mukokutanöz inflamatuar bir hastalıktır. Oral kavitede en sık rastlanan malignite oral skuamöz hücreli karsinomdur(OSHK). Çalışmamızda mukozal savunmada önemli rolü olan Langerhans hücrelerinin OLP ve OSHK’da dağılımını inceleyerek lokal immün cevaptaki rolü hakkında fikir sahibi olmayı amaçladık

Yöntem: 2013-2016 yılları arasında Diş Hekimliği Fakültesi tarafından gönderilen, 36 adet OLP, 28 adet OSHK ve kontrol grubu olarak 10 adet normal mukoza olmak üzere toplam 74 hasta retrospektif olarak yeniden değerlendirilmiş, uygun bloklar seçilerek immunhistokimyasal olarak Langerin antikoru uygulanmıştır. Her olguda 1mm2’lik alanlarda bazal ve suprabazal yerleşimli LH’leri sayılmıştır.

Bulgular: Çalışmamızda OLP olgularında kadın(%60),OSHK olgularında erkek hakimiyeti(%58) izlendi. Yaş dağılımı OLP’larda 53±12 iken OSHK’da 61±21 idi. OLP hastaların %86’sında yanak mukozasında yerleşimli iken OSHK olgularında bu oran sadece %11’di. Langerhans hücre yoğunluğu kontrol grubunda 87(57-105), OLP’da 104(84-143), OSHK’da 82(48-128)’du.

Sonuç: Çalışmamızda LH’lerinde sayısal olarak OLP’lerde kontrol ve OSHK olgularına göre istatiksel olarak anlamlı artış izlenmiştir. Literatürde bu durumlarla ilgili çeşitli farklı sonuçlara rastlamak mümkündür. Langerhans hücrelerinin bu hastalıklardaki yoğunluğunun belirlenmesi, hastalığın patogenezi ve tedavi seçeneklerinin geliştirilebilmesi açısından yol gösterici olabilir.

Keywords

• Oral
• Skuamoz hücreli karsinom
• Liken planus
• Langerhans hücresi

Evaluation of Langerhans Cell Density in Oral Lichen Planus and Squamous Cell Carcinoma

Abstract

Objective: Oral mucosa exposed to many external factors. It has been suggested that oral pathologies may be related to cell-mediated immunity. Dendritic cells are antigen presenting cells that initiate adaptive cellular response. Langerhans cells(LCs), an important member of this group. Oral lichen planus(OLP) is a common chronic mucocutaneous inflammatory disease of unknown etiology. The most common malignancy in the oral cavity is oral squamous cell carcinoma(OSCC). In this study, we aimed to understand the role of LCs in OLP and OSCC which has an important role in mucosal defense.

Method:A total of 74 biopsies taken from Dentistry Department between 2013-2016 were included into the study. The 74 cases;36 OLP, 28 OSCC and 10 normal mucosa as a control group were retrospectively re-evaluated. After selecting appropriate blocks, to evaluate Langerhans cells Langerin was applied immunohistochemically. Basal and suprabasal located immune positive Langerhans cells were counted in 1mm2 areas in each case.

Results:In our study, female(60%) predominancy in OLPs, male predominancy(58%) in OSCCs were reported. Age distribution mean was 53±12 in OLPs and 61±21 in OSCCs. OLP was localized in the buccal mucosa in 86% of patients, whereas this rate was only 11%in OSCC cases. LCs density was 87(57-105) in the control group, 104(84-143) in OLPs, and 82(48-128) in OSCCs.

Conclusion:LC density was found significantly higher in OLPs compared to control group and OSCCs.In literature, variable results were published. Determining the density of Langerhans cells in these diseases can be a guide in terms of the pathogenesis of the disease and the improvement of treatment options.

Keywords

• Oral
• skuamöz hücreli karsinom
• Lichen planus
• Langerhans cell

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