Sanguinaria-associated oral leukoplakia - Comparison with other benign anddysplastic leukoplakic lesions

Objective, This study was undertaken to compare and contrast biomarkers and ploidy data from maxillary gingiva leukoplakias associated with dentifrice s and mouthrinses containing the herbal compound sanguinaria with other for ms of oral benign and premalignant mucosal keratosis. Study design. Representative archived specimens of benign keratosis, sangui naria-associated keratosis, and keratosis with dysplasia were used for comp uterized image analysis and biomarker immunohistochemical assays to assess ploidy, DNA content, and p53 and proliferating cell nuclear antigen immunor eactivity of nuclei. Results. DNA content was significantly higher and higher numbers of cell po pulations with hyperploid nuclei were encountered in the dysplastic group t han in the other two groups (P < .001). Sanguinaria-associated keratosis di d not harbor significant numbers of p53-expressing nuclei, yet it showed a significant elevation in proliferating cell nuclear antigen-labeled nuclei in total, in the basal layer, and in the spinous layer in comparison with b enign keratoses (P < .001). In addition, 1.5% of the sanguinaria-associated leukoplakia epithelial cell population was characterized by nuclei with a greater than 4-fold increase in DNA content. Conclusions. Sanguinaria-associated keratoses show some marker and image an alysis profiles similar to those of nonsanguinaria dysplastic lesions of th e lip and mucosa. Preparations containing sanguinaria should be avoided unt il the risk for malignant transformation is determined.