Quantitative Cellular and Nuclear Volumetric Alterations in Epithelium from Lichen Planus Lesions of Human Buccal Mucosa

Patients with oral lichen planus lesions may represent a relatively high risk population for subsequent development of oral cancer. Little is known of the relative effects of chronic inflammation and the process of malignant transformation itself on the histological structure of transforming epithelia. We have assessed cellular and nuclear volumes in defined basal and spinous cells from normal buccal mucosa epithelium, from epithelium associated with a non-specific chronic inflammatory infiltrate and from lichen planus lesions. Normal (N) tissues were obtained from the margins of non-neoplastic buccal mucosa lesions. Inflammatory (INF) lesions were from areas of the buccal mucosa diagnosed clinically as traumatic irritation without ulceration, and lichen planus (LI) lesions were biopsied from areas exhibiting Wickham's striae. Basal and spinous epithelial cells from normal and pathological human buccal mucosa were measured on haematoxylin and eosin-stained sections imaged through a video camera using a Zeiss VIDAS analyser and from these measurements, nuclear (VN) and cellular (VCELL) volumes were determined. VN and VCELL derived for both basal and spinous strata were similar in N and INF groups but were almost doubled in the LI group. Comparisons between LI and all other groups were significantly elevated. The effects of the inflammatory infiltrate on the oral epithelium in lichen planus and in non-specific inflammation thus differ significantly. VN and VCELL may serve as potential discriminators between benign lesions and premalignant lichen planus.