Expression characteristics of markers of proliferative activity, apoptosis and cell differentiation in patients with premalignant lesions and cancer of the larynx

The purpose of the study was to determine the informative value of р53, CD 138 and Кi 67 markers in mucosal stratified squamous epithelium of patients with precancerous laryngeal lesions and laryngeal cancer. Material and methods. Expression of the above markers was analyzed in 80 patients with chronic laryngeal diseases and in 37 patients with laryngeal cancer. Results. The level of proliferative activity was shown to be directly proportional to more severe dysplastic and neoplastic lesions of the laryngeal mucosa, thus indicating the increased proliferative activity in precancerous lesions and their subsequent malignant transformation. Our data clearly show that suppression of apoptosis is one of the mechanisms of malignant epithelial transformation of epithelial cells. In difficult cases, a sharp increase in the levels of p53 and KI 67 in patients with grade III dysplasia can be considered as an additional criterion for evaluation of risk of malignant transformation. Based on the results obtained, CD138, a cell differentiation marker, is recommended to be considered as an additional criterion for selecting patients with grade II dysplasia into the group being at high risk for laryngeal cancer development. Conclusion. Persistently increased Ki67 expression level serves as an additional criterion for inclusion of patients with precancerous lesions to the group at increased risk of cancer. Alterations in the expression levels of р53 in patients with grade III laryngeal dysplasia are the signs of possible progression of premalignant lesions.