Abstract

Objectives:Oral Submucous Fibrosis (OSMF) is potentially malignant disorder known to transform into oral cancer. The aim of this study is to determine the degree and pattern of expression of aberrant Ki67 in OSMF, oral squamous cell carcinoma (OSCC) and in normal oral mucosa patients (NOM). The objective is to correlate between Ki67 expression and degree of dysplasia in OSMF patents and also Ki67 expression with clinical and histological grading of OSMF and OSCC patient. Materials and Methods:A prospective cross-sectional study was conducted with purposive sampling technique from Jan 2017 to April 2020.The study groups consist of 35 OSMF cases, 10 cases of each OSCC and NOM. The samples were immunohistochemically analyzed for expression Ki67 antigen using chi-square test (P < 0.05).Results:The expression of Ki67 was significantly higher in OSMF than that of NOM samples, but less than that of OSCC samples. Present study showed correlation between expression of Ki67 with clinical staging and histological grading both in OSMF and OSCC patients. Conclusion:The study demonstrated a high incidence of Ki67 over expression in, OSMF and OSCC. Hence, Ki-67 can be widely used as a proliferation marker to measure growth fraction of cells in OSMF and also for determining the severity of epithelial dysplasia.

Highlights

  • Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder (PMD) of the oral cavity seen predominately in the Indian subcontinent and South East Asia (Wollina et al, 2015)

  • Oral Submucous Fibrosis (OSMF) is potentially malignant disorder known to transform into oral cancer

  • This study aims i) to determine the degree and pattern expression of aberrant Ki67 in OSMF, oral squamous cell carcinoma (OSCC) and in normal oral mucosal patients (NOM) ii) to correlate between Ki67 expression and degree of dysplasia in OSMF patents iii) to correlate Ki67 expression with clinical and histological grading of OSMF and OSCC patient and to show Ki67 antigens surrogatebiomarker useful in detecting high-risk OSMF patients for malignant transformation (MT)

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Summary

Introduction

Oral Submucous Fibrosis (OSMF) is a potentially malignant disorder (PMD) of the oral cavity seen predominately in the Indian subcontinent and South East Asia (Wollina et al, 2015). Many recent epidemiological studies show that there is marked increase in the prevalence of OSMF (Manjunath et al, 2019; Nigam et al, 2014). Previous data and intervention studies suggest that areca nut is the main etiological factor for OSMF and is the fourth most commonly used psychoactive substance in the world (following nicotine, ethanol and caffeine) (Shrikrishna et al.,2016; Narang et al, 2017; Yang et al, 2018). One of the important hallmarks of malignant transformation (MT) is the uncontrolled growth rate, commonly reflected as increased cell proliferation (Humayun et al, 2011). High proliferative activity and basal cell hyperplasia in conjunction with rapid exfoliation of superficial cells and epithelial atrophy suggest that epithelial turnover rate is very high in OSMF (Reddy et al, 2016)

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