ORIGINAL RESEARCH
Pathology
doi: 10.25005/2074-0581-2026-28-3-675-684
COMPREHENSIVE ANALYSIS OF HISTOLOGICAL CHANGES IN THE LIP MUCOSA IN CHRONIC CHEILITIS

A.F. SOLNYSHKINA1, O.N. GUSKOVA1, S.N. LEBEDEV2

1Department of Pathological Anatomy, Tver State Medical University, Tver, Russian Federation
2Department of Surgical Dentistry and Maxillofacial Surgery, Tver State Medical University, Tver, Russian Federation

Objective: To assess the relationship between epithelial and stromal changes in chronic cheilitis in order to identify prognostic criteria for malignant transformation.

Methods: A retrospective analysis was performed of 46 cases of lip resections with histologically confirmed chronic cheilitis during the period from May 2022 to December 2024. Patients were divided into two groups: Group A (n=24) – without epithelial dysplasia; Group B (n=22) – with low- and highgrade epithelial dysplasia. The age and demographic characteristics of the groups did not differ significantly (p>0.05). A comprehensive morphological analysis was performed, including histology (hematoxylin and eosin staining, PAS reaction) and immunohistochemistry with CD31 antibodies to assess microvascular density (MVD) according to the Weidner method. Stromal morphometry was performed using the “Video Test-Morphology 5.2” software.

Results: Dysplastic changes were identified in Group B, including disruption of keratinocyte polarity, nuclear hyperchromasia, and pathological mitoses. The karyopyknotic index was 14.6±2.1% compared with 8.2±1.4% in Group A (p<0.001). MVD was significantly higher in Group B than in Group A (26.7±4.1 vs. 18.4±3.2 vessels per field of view, ×200; p<0.001). The vascular-to-stromal ratio in Group B reached 1.38±0.12 vs. 0.92±0.09 in Group A; p<0.001. A strong positive correlation was found between the degree of dysplasia and MVD (r=0.81; p<0.01).

Conclusion: Chronic cheilitis with epithelial dysplasia is characterized not only by atypia of the epithelial layer but also by remodeling of the stromal microenvironment with activation of angiogenesis. Increased MVD and the vascular-to-stromal ratio reflect the formation of a pro-oncogenic microenvironment at the precancerous stage. Quantitative assessment of MVD using CD31 demonstrates high prognostic value for determining the risk of malignant transformation. These findings support the concept of a “field of cancerization”, according to which interactions between the epithelium and stroma determine carcinogenic transformation. Incorporating morphometric parameters (MVD and the karyopyknotic index) into diagnostic algorithms may help optimize patient management by identifying a high-risk group requiring intensified surveillance or preventive treatment. The results are consistent with evidence regarding the key role of angiogenesis in the progression of precancerous conditions and support the need to introduce standardized criteria for quantitative assessment into routine histopathological practice. for more detailed stratification of oncological risk.

Keywords: Vermilion border of the lips, dysplasia, microvascular density, cheilitis, CD31, angiogenesis.

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Authors' information:

Solnyshkina Anna Fyodorovna,
Candidate of Medical Sciences, Associate Professor of the Department of Pathological Anatomy, Tver State Medical University
ORCID ID: 0009-0005-7182-807X
SPIN: 9054-4023
Author ID: 1276038
E-mail: solnyshkinaaf@tvgmu.ru

Guskova Oksana Nikolaevna,
Candidate of Medical Sciences, Associate Professor of the Department of Pathological Anatomy, Tver State Medical University
ORCID ID: 0000-0003-1635-7533
SPIN: 1481-6648
Author ID: 306980
E-mail: guskovaon@tvgmu.ru

Lebedev Sergey Nikolaevich,
Doctor of Medical Sciences, Professor of the Department of Surgical Dentistry and Maxillofacial Surgery, Tver State Medical University
ORCID ID: 0000-0002-8118-4977
SPIN: 7302-6470
Author ID: 732488
E-mail: lebedev_s@tvergma.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Solnyshkina Anna Fyodorovna
Candidate of Medical Sciences, Associate Professor of the Department of Pathological Anatomy, Tver State Medical University

170100, Russian Federation, Tver, Sovetskaya str., 4

Tel.: +7 (910) 8393537

E-mail: solnyshkinaaf@tvgmu.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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