Experimental study on the structure and immune cell phenotypes of the lymphoid tissues in oral lichenoid lesions

doi:10.19439/j.sjos.2021.02.001

Abstract

Abstract: PURPOSE: To evaluate the existence of tertiary lymphoid structures(TLS) in oral lichenoid lesions and its compositional characteristics of immune cells. METHODS: Tissue samples of normal oral mucosa, oral lichen planus (OLP) and oral lichenoid tissue reaction(OLTR) were collected, thirty cases in each group. Hematoxylin-eosin(H-E) staining was performed to identify the TLS-like structures, and immunohistochemistry (IHC) staining was applied to assess the structure and amount of infiltrating CD3⁺ T cells, CD19⁺, CD20⁺ B cells, CD21⁺ follicular dendritic cells (FDC), Bcl-6⁺ germinal centers, CD34⁺ PNAd⁺ venules and CD34⁺ Gp36⁺ micro lymphatic vessels in TLS of OLL. Histopathology and molecular markers were used to evaluate the morphological performance of TLS in OLL. Chi-square test (Fisher exact probability method) was applied to compare the proportion of TLS in each group; integral optical density (IOD) method was used to calculate the expression level of each molecular marker, nonparametric t test (Mann-Whitney U test) was employed to analyze their difference. Statistical analysis was performed with GraphPad Prism 7.0 software. RESULTS: In OLP group and OLTR group, 46.7% (14/30) and 23.4% (7/30) cases had TLS-like structures, respectively. The frequency of TLS-like structures was not correlated with the type of disease(P>0.05). Compared with the control group, the molecular markers in OLP group and OLTR group were highly expressed, and the expression of CD19, CD20, and CD21 in OLP group had morphological and structural characteristics of TLS. The expression of Bcl-6(mean and standard deviation of IOD were 15 498±15 108 vs. 1 841±2 276, P<0.000 1), CD20 (13 067±9 049 vs. 7 695±5 159, P<0.05), CD21 (13 968±14 560 vs. 2 552±2 584, P<0.000 1), PNAd (10 328±10 383 vs. 1 756±1 570, P<0.000 1) and Gp36 (12 778±12 390 vs. 2 313±2 578, P<0.000 1) showed significant differences between OLP and OLTR tissues, but it could not be used as the criteria for identifying the type of diseases without morphological characters. CONCLUSIONS: TLS exists in OLL lesions, mainly presented as non-classical forms. The classical forms can be occasionally found. CD20 and CD21 can be used as the biomarkers to identify the TLS in OLL. TLS can not be used as the diagnosing criteria for identifying OLP or OLTR.

Key words: Oral lichenoid lesion, Oral lichen planus, Tertiary lymphatic structure, Lymphoid follicle-like structure

CLC Number:

R781.5

LI Jing-jing, SONG Chen-cheng, LI Chen-xi, XIA Rong-hui, DENG Yi-wen, WANG Yu-feng, TANG Guo-yao. Experimental study on the structure and immune cell phenotypes of the lymphoid tissues in oral lichenoid lesions[J]. Shanghai Journal of Stomatology, 2021, 30(2): 113-119.

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