p53 Overexpression in Oral Mucosa in Relation to Shisha Smoking in Syria and Lebanon

Document Type : Research Articles


1 Faculty of Dentistry, Al-Sham Private University, Damascus, Syria.

2 Department of Periodontology, Lebanese University, Lebanon.

3 Department of Oral Histology and Pathology, Faculty of Dentistry, Damascus University Damascus, Syria.


Introduction: Shisha (waterpipe) smoking is becoming a very prevalent form of tobacco consumption in the Middle
east and use is growing over the world. Smoking-related malignancies have a high genome-wide burden of mutations,
including examples in the gene encoding p53. Aims: To investigate alterations in p53 immunohistochemical expression
in the normal, pre-malignant, malignant oral mucosa in relation to Shisha smoking habits. Materials and Methods:
A total of 105 paraffin embedded tissue sections of OSCCs (52 smokers,53 non-smokers), 96 of premalignant lesions
(48 smokers,48 non-smokers) and 60 normal oral mucosa. Some 30 patients with a history of Shisha smoking daily
for more than 5 years were also investigated for mutant expression of p53. Tissue samples were considered positive
for p53 staining when any positive cells of epithelial origin could be detected. Results: The majority (74.3%) of oral
squamous cell carcinomas showed positive staining for p53 expression (83.1% and 65.5% with Shisha smokers and
non-smokers, respectively). In the 96 premalignant lesions, about 23% from non-smokers and 41.7% from smokers
showed p53 positivity. In normal epithelium, P53 positive cells were noted in 6.6% of non-smokers and 16.6% of
smokers. Positive correlations with Shisha smoking were evident for the following groups: WDOSCC, MDOSCC,
mild dysplasia G1, moderate dysplasia G2 and in normal mucosa using Student’s t- test, P valueThese results strongly suggest that p53 mutations are associated with Shisha smoking in OSCC, pre-malignant lesions
and normal mucosa of the oral cavity.


Main Subjects