Morphological Diagnosis of Cheilitis Morphological Diagnosis of Cheilitis

BACKGROUND: The red border of the lips is under the influence of external and internal environmental factors that can cause inflammation. Tissue damage initiates a cascade of molecular processes that, under unfavorable conditions, trigger oncogenesis.

AIM: To evaluate morphological changes in the mucosal layer of lips in patients with chronic cheilitis.

METHODS: A retrospective morphological examination was performed on biopsy material of the lip mucosa of 46 patients aged 34–72 years (19 women and 27 men, average age 63.02) with chronic cheilitis without signs of integumentary epithelial dysplasia (n=24) and with low and high degree dysplastic changes (n=22). Changes in the epithelial layer, severity of hyperplasia, cellular composition, degree of maturation of epitheliocytes, karyopycnotic index, features of inflammatory infiltrate and vascularization of its own mucosal lamina were evaluated. Microscopic examination was performed using an Olympus CX-41 light microscope with a digital camera. In the Video Test-Morphology 5.2 software, 10 fields of view of a microscope (volume 40, approx 10) were studied in each preparation: the diameter, number, numerical density of blood vessels, and the ratio of stromal and angiomatous components were measured per 1 mm² area. The data was statistically processed using the SPSS Statistics program, version 22.0.

RESULTS: The groups were dominated by older men. A comparative analysis of changes in the integumentary multilayer squamous epithelium, the inflammatory reaction, and the nature of vascularization of the intrinsic lamina of the mucosa was performed. It was found that in patients of group B the number of vessels per unit area was significantly higher than in group A. Microscopic features of reactive changes in the epithelium and the intrinsic plate of the mucous membrane of the red border of the lips, predisposing to malignant transformation, have been identified. In chronic cheilitis with integumentary epithelial dysplasia, an uneven arrangement of vascular loops with alternating sections of hypovascularized stroma and foci of increased vascularization of the own mucosal plate due to the accumulation of small capillaries was noted, which can be recommended as a morphological sign of an unfavorable prognosis.

CONCLUSION: In the differential diagnosis of lip diseases, pathologists should conclude by noting, along with the characteristics of multilayer squamous epithelium dysplasia, the nature and severity of microcirculatory changes and inflammatory infiltration in the mucous membrane, and clinicians should take into account morphological data when choosing treatment tactics for patients.