Immunohistochemical Expression of Podoplanin in Clinical Variants of Oral Leukoplakia and Its Correlation With Epithelial Dysplasia

Oral leukoplakia is the most common premalignant lesion of the oral cavity and is associated with development of oral squamous cell carcinoma. Certain changes at cellular and molecular level are important indicators for transformation into carcinoma. Podoplanin, a transmembrane glycoprotein is involved in the cytoskeletal remodeling and increased motility of the cell which helps in determining the malignant potential of oral leukoplakic lesions. The objective of the study was to determine immunohistochemically the expression of podoplanin in homogenous (HOL) and nonhomogenous oral leukoplakia (NHOL) and to compare the expression with clinicopathological parameters. Study group included 15 cases each of HOL, NHOL and control group included 15 healthy volunteers. Both tissues were immunohistochemically stained for podoplanin (D2-40) antibody. No statistical significant difference was observed between the study and control groups for expression of podoplanin but significant difference was observed on comparison of podoplanin scores between HOL and NHOL. Statistical significant difference was observed when the podoplanin expression in the epithelium and the lymphatic vessel density were correlated with the histologic grading of HOL and NHOL. Expression of podoplanin was greater in NHOL as compared with HOL, this supports the fact that NHOL has a greater risk of malignant transformation when compared with HOL. Podoplanin expression, lymphangiogenesis, and lymphatic vessel density increased with increasing grades of dysplasia, suggesting that cellular modeling and motility is increased as the grade of dysplasia advances. Thus suggesting podoplanin can be used as a prognostic marker to determine the malignant potential in oral leukoplakias.