FROM EPITHELIAL DYSPLASIA TO SQUAMOUS CARCINOMA OF THE HEAD AND NECK REGION - EVOLUTIVE AND PROGNOSTIC HISTOPATHOLOGICAL MARKERS

Ki67 immunoreactivity, p53 expression and apoptotic index were examine d in 26 non-malignant lesions of the head and neck region, 22 dysplast ic lesions of patients without evidence of head and neck carcinoma dur ing follow-up time, 24 dysplastic lesions of patients who subsequently developed a squamous carcinoma in the same area, and 42 squamous canc er cases. A directly proportional relation between Ki67 immunoreactive pattern, apoptotic index and histological evolution from normal to dy splastic or neoplastic mucosa was evident. As far as p53 protein is co ncerned, its expression became higher and frequently transmural in neo plastic mucosa. A strict. correlation between frequency and density of Ki67/p53 immunoreactivity according to invasive cell grading (ICG) sc ores and poor prognosis of patients were found. On the contrary, malig nant cells highly expressing p53 seemed nor to undergo apoptosis. Ki67 antigen and p53 protein detection in premalignant lesions and in carc inomas of the head and neck tract could be a useful marker for the man agement of patients at risk.