Abstract
Candida albicans (C. albicans) play a significant role in oral mucosal carcinogenesis. It can be identified using various techniques in cytological smears. But, very few studies have been conducted on histopathological sections using calcofluor white M2R under fluorescent microscopy. Additionally, detection and quantification of Candida colonies and its correlation with various grades of oral leukoplakia and oral carcinomas have not been explored much. The current retrospective study included 80 samples from archives consisting of 60 samples in the study group (10 cases each of mild, moderate, and severe epithelial dysplasia (totally 30) and 30 cases of oral carcinoma). Sections were stained with calcofluor white (CFW) and 10% KOH for the observation under fluorescent microscopy and correlated with different grades of oral leukoplakia and oral carcinomas. Chi-square test was used in SSPS software to study the presence and absence of Candida sp. in different groups. The study groups of oral carcinoma and dysplasia showed a significant association with Candida sp. (P=0). When carcinoma was compared with each grade of dysplasia, except mild dysplasia (P=4.4E-05), both moderate (P=0.402195) and severe dysplasia (P=0.558746) showed an insignificant P-value. When the groups of mild (13.3%), moderate (30%), and severe (33.3%) dysplasia were considered independently, the incidence of Candida sp. increased as the grade of dysplasia increased. The number of colonies have been counted and the maximum number of colonies have been observed in carcinoma and the least have been observed in mild dysplasia. A significant association of Candida colonies with epithelial dysplasia and oral cancer was established. Further, CFW was found a promising candidate to identify Candida colonies in tissue sections using fluorescent microscopy.
Highlights
The incidence of oral precancers and carcinomas is rising at an alarming rate in India and causing major health care concerns
The number of colonies have been counted and the maximum number of colonies have been observed in carcinoma and the least have been observed in mild dysplasia
Candida albicans are the dwellers of normal flora of oral and gastrointestinal tract [7], the key species associated with human oral mycoses, and the most lethal among pathogenic Candida species [8]
Summary
The incidence of oral precancers and carcinomas is rising at an alarming rate in India and causing major health care concerns. Oral cancers are reported in patients with questionable habits and the role of microbes have been postulated by the researchers. Have the normal oral microflora proved to be strongly associated with carcinogenesis; its detailed etiopathogenesis needs analysis. There is plethora of literature, which point to a strong association of Candida sp. With oral cancer, but there are scarcely any studies establishing the association of Candida sp. In dysplastic alteration in the epithelium [1] There is plethora of literature, which point to a strong association of Candida sp. with oral cancer, but there are scarcely any studies establishing the association of Candida sp. in dysplastic alteration in the epithelium [1].
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