Vol. 11, Issue 3, Part F (2025)

Background: Oral potentially malignant disorders (PMDs) carry a variable but significant risk of progression to oral squamous cell carcinoma (OSCC). Traditional histopathological grading remains the diagnostic gold standard; however, its predictive accuracy is limited. Molecular biomarkers reflecting alterations in proliferation, differentiation, and apoptosis may provide valuable adjunctive information. The aim of study is to evaluate the expression of p53, epidermal growth factor receptor (EGFR), and Bcl-2 in PMDs and their predictive potential for malignant transformation.

Materials and Methods: 30 archival formalin-fixed paraffin-embedded (FFPE) tissues were analyzed, comprising 10 hyperplastic tissues (HPTs), 10 PMDs, and 10 well-differentiated squamous cell carcinomas (WDSCCs). Immunohistochemistry was performed using monoclonal antibodies against p53, EGFR, and Bcl-2. Expression patterns were assessed in basal, suprabasal, and keratin layers, as well as in peripheral and central tumor islands. Statistical analyses included Wilcoxon signed-rank test, with p<0.05 considered significant.

Results: p53 expression was detected in 30% of HPTs, 70% of PMDs, and 100% of WDSCCs, with a significant increase across the spectrum (p<0.001). EGFR expression was membranous in HPTs and PMDs but demonstrated mixed membranous and cytoplasmic localization in WDSCCs (p<0.001). Bcl-2 positivity was observed in 40% of HPTs, 60% of PMDs, and 100% of WDSCCs, with a progressive extension from basal to suprabasal layers (p<0.001). Both p53 and Bcl-2 showed statistically significant co-expression trends in PMDs and WDSCCs.

Conclusion: The gradual upregulation of p53, EGFR, and Bcl-2 from HPTs to PMDs and OSCC underscores their significance in oral carcinogenesis. These biomarkers may function as significant supplements to histopathological grading, facilitating risk categorisation of PMDs and informing early therapeutic action. It is advisable to conduct larger investigations utilising broader molecular panels to confirm their prognostic efficacy.