Expression of MDM2, Sox2 and Ki 67 biomarkers in cutaneous and oral lichen planus

Abstract

Lichen planus is a chronic inflammatory mucocutaneous disease that commonly affects the skin, mucous membranes, and, less frequently, hair and nails. In some studies, it has been identified as a potentially premalignant lesion, with the capacity to progress to oral squamous cell carcinoma. Identifying reliable biomarkers for detecting malignant transformation plays a significant role in the screening and monitoring of patients with premalignant lesions. Therefore, this study aims to assess the expression levels of MDM2, Sox2, and Ki-67 to evaluate their potential roles as indicators of malignant transformation in lichen planus. This research specifically examines the expression of these biomarkers in both oral and cutaneous forms of lichen planus. Methods: This cross-sectional study included adult patients (aged 18 to 60) diagnosed with lichen planus who visited Sina Hospital in Tabriz between April 2022 and June 2023. Sample collection was conducted via simple sampling and a census approach, encompassing all eligible patients within the specified timeframe. A total of 25 patients with cutaneous lichen planus and 25 patients with oral lichen planus were included. The diagnosis of lichen planus was based on patient history, clinical signs, physical examination, and biopsy results. Findings: The expression levels of the biomarkers MDM2, Sox2, and Ki-67 were evaluated in cutaneous and oral tissue samples from patients with lichen planus. Results indicated variable expression levels across the samples, with Ki-67, Sox2, and MDM2 showing both low and high expression in different cases. Expression levels of these biomarkers were further analyzed across different types of oral lichen planus (reticular and erosive), with significant differences observed between them. Additionally, the relationship between MDM2, Sox2, and Ki-67 expression levels was assessed in cutaneous and oral samples. A significant correlation was found in oral samples, while no significant difference was observed in cutaneous samples. Furthermore, the expression levels of these biomarkers were analyzed in various regions of oral lesions, revealing significant differences. Lastly, the staining patterns of these biomarkers were compared between basal and suprabasal layers and connective tissue, showing no statistically significant differences in staining patterns.