To Determine the Immune Check Point Protein Expression CTLA-4 and VISTA With Clinical and Pathological Staging of Potential Oral Malignant Lesions by Immunohistochemistry Analysis.

INTRODUCTION: The immune microenvironment is essential in the development of leukoplakia. Which is a potentially precancerous lesion with increased chances of evolving into oral squamous cell carcinoma (OSCC). One of the most significant co-stimulatory molecules involved in the negative regulation of T cells during carcinogenesis is the immunological check point protein V-domain Ig Suppressor of T-cell Activation (VISTA), also known as CTLA-4. The VISTA and CTLA-4 serves as a emerging new biomarker in early detection and to determine malignant potential of leucoplakia.

MATERIAL AND METHOD: Tissue samples from patients with suspected oral malignant lesions were analyzed using immunohistochemistry (IHC). We used established scoring methods to analyze the expression levels of CTLA-4 and VISTA. Clinical finding and histopathological grading were established. The association between the patterns of protein expression and the clinicopathological features was discovered by statistical analysis.

RESULT: VISTA expression varied among the different dysplasia grade with a non-linear relationship observed between VISTA expression and the severity of dysplasia. There was a progressive rise in CTLA 4 positivity that paralleled the severity of dysplasia.

CONCLUSION: CTLA 4 expression could serve as a helpful indicator for determining the risk of malignant transformation in oral potentially malignant disorders.