Comparative Evaluation of P21 Marker Detection in Squamous Cell Carcinoma and Leukoplakia Using Enhanced Immunohistochemical Techniques: An Original Research Study

Abstract

Aim: This study aims to evaluate the p21 marker detection in Squamous Cell Carcinoma and Leukoplakia using enhanced Immunohistochemical Techniques

Materials and Methods: This study involved 80 cases of predefined lesions, including 40 individuals with Oral Squamous Cell Carcinoma (OSCC) and 40 with Leukoplakia. Strict criteria ensured balanced gender representation and excluded samples with smoking history or necrotic tissue. All patients consented, and none were on medications affecting the study. Samples were prepared as four-micron Paraffin sections, treated with a 3% Peroxidase solution, and stained with Monoclonal Antibodies. After Haematoxylin staining and dehydration, slides were examined microscopically at 100x and 400x magnification, using melanoma tissue as a control. Nuclei were counted and analysed using Broder’s Grading system, while staining intensity was assessed by a pathologist as (+) mild, (++) moderate, and (+++) intense.

Statistical Analysis and Results: A study analysed 80 patients with predefined lesions, split into two groups: 40 with Oral Squamous Cell Carcinoma (OSCC) and 40 with Leukoplakia. The findings showed a higher prevalence of males (44 males vs. 36 females). In Group 1 (OSCC), p21 marker expression revealed 5 patients (12.5%) with mild staining, 15 (37.5%) with moderate staining, and 20 (50%) with intense staining, indicating a potential link between high p21 expression and aggressive tumour characteristics. In Group 2 (Leukoplakia), 10 patients (25%) had mild staining, 10 (25%) moderate, and 15 (37.5%) intense staining. A one-way ANOVA assessed the significance of p21 staining intensity across groups, suggesting p21's role as a biomarker for tumour progression in both malignant and precancerous conditions.

Conclusion: This study concluded that p21 expression was moderate in oral SCC patients compared to Leukoplakia, with higher levels indicating greater disease severity. While Leukoplakia showed some p21 expression, it was weaker than in SCC. The research highlighted a significant increase in p21 from normal tissue to Leukoplakia and then to SCC, emphasizing the need for further studies to enhance clinical applications.