Comparação dos aspectos histomorfométricos entre lesões de líquen plano oral e lesões liquenoides orais

Abstract

Introduction: Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are considered potentially malignant oral disorders characterized by the presence of lacy white streaks, which may be accompanied by other clinical subtypes. The differential diagnosis between these conditions must be well established, since the two diseases have many characteristics in common, presenting similar symptoms, clinical manifestations and histopathological characteristics. A combination of clinical and histopathological evaluation should be performed, as well as the use of other methods, such as histomorphometry, which provides more objective analyses. Objective: To analyze the clinical-pathological and histomorphometric data of OLP and OLL lesions in order to verify differences that justify the distinct biological behavior between the lesions. Methodology: retrospective cross-sectional study, based on 30 histological sections of incisional biopsies of OLP (n = 15) and LLO (n = 15), diagnosed according to the diagnostic criteria of the WHO classification (2021), in the period between 2009 and 2016. The histological sections were stained with hematoxylin and eosin and the analyses, which were performed under light microscopy, included morphological parameters, such as keratosis, acanthosis, band of inflammatory infiltrate and eosinophilic band, degeneration of the basal layer and involvement of the epithelium-chorion interface and degree of subepithelial inflammatory infiltrate, and morphometric parameters, such as keratin thickness, distance from the basal layer to the epithelial surface, thickness of the band of inflammatory infiltrate and cell density, performed by two previously calibrated evaluators. Results: It was observed that 66.7% of the sample were women, over 40 years old (90%), the most common clinical subtype associated was plaque (53.3%) and the most affected site was the buccal mucosa and retromolar region (90%) for both lesions. However, there was no significant association between the type of lesion and the clinical and histomorphological characteristics of the patients (p>0.05), except for the degree of dysplasia (p=0.0003). There was no significant difference between the two types of lesion regarding the histomorphometric variables evaluated (p>0.05). Regarding the cellular density of the inflammatory infiltrate in the OLP and OLL lesions, no association was found between the histomorphometric variables studied and both conditions. Conclusion: In the sample studied and based on the methodology used in the present study, it was found that OLP and LLO lesions shared similarities between them for the clinical and histomorphometric variables evaluated, which suggests that such conditions appear to portray a spectrum of presentation of the same disease.