Role of Podoplanin in Potentially Malignant Disorders and Oral Squamous Cell Carcinoma and Its Correlation with Lymphangiogenesis

Background: Oral squamous cell carcinoma (OSCC) ranks as one of the most common types of cancer and oral potentially malignant lesions (OPMLs) provides with an overall increased risk for development of carcinoma. As podoplanin expression is attracting interest as a marker for cancer diagnosis and prognosis, this study assesses the role of podoplanin expression in such lesions.

Materials And Methods: Podoplanin expression and lymphatic vessel density (LVD) was determined using D2-40, a marker for podoplanin, in 70 diagnosed cases of potentially malignant lesions and OSCC.

Results: Normal epithelium showed negligible podoplanin expression, whereas the expression extended predominantly at the basal layer and the suprabasal layer or above at one or multiple areas in potentially malignant lesions. Podoplanin expression in OSCC showed two different patterns-diffuse and focal. A statistically significant increase in mean LVD was seen from normal epithelium to potentially malignant lesions (P < 0.001) and to OSCC (P < 0.022) while a non-significant increase was seen (P < 0.594) between OPMLs and OSCC. Overall no significant correlation was found between D2-40 epithelial positivity and LVD (P = 0.122).

Conclusion: This study suggests the utility of podoplanin as a biomarker for cancer risk assessment as it detects the early changes and thus provides an additional value beyond current clinical and histopathological evaluations. Hence, podoplanin is suggested to be a marker of tumor initiation and to a lesser extent of tumor progression.