High Incidence Of Oral Cancer Research Articles

Evaluation of Plant Essential Oils as Natural Alternatives for Alcohol-based Mouthwashes: Spotlight—Lemongrass and Citronella Java

Abstract Objective The purpose of our study was to evaluate plant-derived essential oils (EOs) as natural alternatives to commercial alcohol-based mouthwashes in the prevention of dental caries since several recent studies have linked high incidence of oral cancer among users with a history of prolonged use of alcohol-based mouthwashes. Materials and Methods Lemongrass, Citronella Java, Gingergrass, and Caraway seed EOs were tested against commonly occurring multidrug-resistant (MDR) oral bacteria namely Micrococcus luteus, Enterococcus faecalis, Streptococcus oralis, and Streptococcus salivarius. Agar well diffusion method was used to determine the antibacterial effectiveness of these EOs. Samples of Citronella Java and Lemongrass EO were also analyzed by gas chromatography (GC). Results Lemongrass and Citronella Java exhibited the highest antibacterial activity against all four bacterial strains. Inhibition zones of Lemongrass were 12, 21.3, 28.3, and 32 mm in diameter against E. faecalis, M. luteus, S. oralis, and S. salivarius, respectively. In comparison, inhibition zones of Citronella Java were 11.5, 17, 20.7, and 20.2 mm in diameter against E. faecalis, M. luteus, S. oralis, and S. salivarius, respectively. A significant finding in our study was that antibacterial activity of Lemongrass was much higher than that of tetracycline, a broad-spectrum antibiotic, against S. oralis and S. salivarius, while the inhibitory effects of Citronella Java against these two oral streptococci were comparable to tetracycline. The major components of Citronella Java identified by GC were citronellal, citronellol, and geraniol, whereas Lemongrass was primarily composed of cis and trans forms of citral. Conclusion Our results suggest that Lemongrass and Citronella Java could be promising natural alternatives to alcohol-based mouthwashes against MDR oral bacteria in the prevention of dental caries.

Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India.

There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion. A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis. Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study. Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Exploring the comprehensive review of diagnostic methods of oral cancer: A global scenario

Oral cancer is one of the common cancers in the worldwide, with a delayed clinical detection and prognosis. There is no specific biomarkers for this kind of disease and also no expensive therapeutic alternative methods. It is two to three times more prevalent in men than women in most ethnic groups. It is a preventable disease, where smoking and alcohol-considered major risk factors. India has one of the highest incidences of oral cancer and delayed stage recovery is common. Surgery remains the treatment of choice and adjuvant treatment is recommended in patients with high-risk. Functional outcomes and treatment-related morbidity needs to be considered, and reconstruction with free tissue transfer provides the best outcomes. Particularly while speech, swallowing, mastication efficiency, and dental rehabilitation. Future generations has to fight these dreadful diseases until scientists and clinicians are provided the opportunities to expand efforts to prevent, detect (early), and eradicate oral and other head and neck cancers.

Ursolic acid-loaded chitosan nanoparticles suppress 7,12-dimethylbenz(a)anthracene-induced oral tumor formation through their antilipid peroxidative potential in golden Syrian hamsters.

Oral cancer, a disfiguring and life threatening cancer, significantly affects the day-to-day life of not only the patients but also their family members in terms of life quality and financial burden. India records higher incidence of oral cancer every year and is mainly due to the habituation of tobacco products and alcohol abuse. Delay in diagnosis and treatment influences India's higher incidence of oral cancer, where annually 50,000-60,000 oral carcinoma cases are reported. 7,12-dimethylbenz(a)anthracene (DMBA)-induced cancer in the oral cavity mimics human oral cancer in histopathological, molecular, and morphological aspects, and thus, by using this paradigm, the tumor inhibiting efficacy of medicinal plants or herbs and their components is scientifically validated. Ursolic acid, due to its multiple pharmacological effects, has been attracted, in recent years, for chemoprevention research program. Though, ursolic acid has been shown to have beneficial effects, its poor water solubility and bioavailability hinder to exert its 100% efficacy. Therefore, ursolic acid is encapsulated in either natural or synthetic polymers to enhance its therapeutic efficacy. Chitosan is one of the natural polymers that have been employed in the synthesis of nanoparticles to improve the drug efficacy. The present study has thus chosen ursolic acid-loaded chitosan nanoparticles (UACNP) to assess its anticancer efficacy in the DMBA-induced oral carcinoma. The anticancer efficacy of UACNP in experimental oral carcinogenesis was assessed by employing the status of oxidative markers and detoxification cascade as an end point. DMBA-induced abnormalities in the status of oxidative markers and detoxification cascade were reversed by ursolic acid-loaded chitosan nanoparticles. The tumor inhibiting or suppressing effect of UACNP is thus explored in experimental oral carcinogenesis.

Bioactive phytocompounds for oral cancer prevention and treatment: A comprehensive and critical evaluation.

The high incidence of oral cancer combined with excessive treatment cost underscores the need for novel oral cancer preventive and therapeutic options. The value of natural agents, including plant secondary metabolites (phytochemicals), in preventing carcinogenesis and representing expansive source of anticancer drugs have been established. While fragmentary research data are available on antioral cancer effects of phytochemicals, a comprehensive and critical evaluation of the potential of these agents for the prevention and intervention of human oral malignancies has not been conducted according to our knowledge. This study presents a complete and critical analysis of current preclinical and clinical results on the prevention and treatment of oral cancer using phytochemicals. Our in-depth analysis highlights anticancer effects of various phytochemicals, such as phenolics, terpenoids, alkaloids, and sulfur-containing compounds, against numerous oral cancer cells and/or in vivo oral cancer models by antiproliferative, proapoptotic, cell cycle-regulatory, antiinvasive, antiangiogenic, and antimetastatic effects. Bioactive phytochemicals exert their antineoplastic effects by modulating various signaling pathways, specifically involving the epidermal growth factor receptor, cytokine receptors, toll-like receptors, and tumor necrosis factor receptor and consequently alter the expression of downstream genes and proteins. Interestingly, phytochemicals demonstrate encouraging effects in clinical trials, such as reduction of oral lesion size, cell growth, pain score, and development of new lesions. While most phytochemicals displayed minimal toxicity, concerns with bioavailability may limit their clinical application. Future directions for research include more in-depth mechanistic in vivo studies, administration of phytochemicals using novel formulations, investigation of phytocompounds as adjuvants to conventional treatment, and randomized clinical trials.

Oral epithelial cell segmentation from fluorescent multichannel cytology images using deep learning

Background and objectivesCytology is a proven, minimally-invasive cancer screening and surveillance strategy. Given the high incidence of oral cancer globally, there is a need to develop a point-of-care, automated, cytology-based screening tool. Oral cytology image analysis has multiple challenges such as, presence of debris, blood cells, artefacts, and clustered cells, which necessitate a skilled expertise for single-cell detection of atypical cells for diagnosis. The main objective of this study is to develop a semantic segmentation model for Single Epithelial Cell (SEC) separation from fluorescent, multichannel, microscopic oral cytology images and classify the segmented images. MethodsWe have used multi-channel, fluorescent, microscopic images (number of images; n = 2730), which were stained differentially for cytoplasm and nucleus. The cytoplasmic and cell membrane markers used in the study were Mackia Amurensis Agglutinin (MAA; n: 2364) and Sambucus Nigra Agglutinin-1 (SNA-1; n: 366) with a nuclear stain DAPI. The cytology images were labelled for SECs, cluster of cells, artefacts, and blood cells. In this study, we used encoder-decoder models based on the well-established U-Net architecture, modified U-Net and ResNet-34 for multi-class segmentation. The experiments were performed with different class combinations of data to reduce imbalance. The derived MAA dataset (n: 14,706) of SEC, cluster, and artefacts/blood cells were used for developing a classification model. InceptionV3 model and a new custom Convolutional-Neural-Network (CNN) model (Artefact-Net) were trained to classify SNA-1 marker stained segmented images (n:6101). For segmentation models, Intersection Over Union (IoU) and F1 score were used as the evaluation matrices, while the classification models were evaluated using the conventional classification metrics like precision, recall and F1-Score. ResultsThe U-Net and the modified U-Net models gave the best IoU overall (0.73–0.76) as well as for SEC segmentation (079). The images segmented using the modified U-Net model were classified by Artefact-Net and Inception V3 model with F1 scores of 0.96 and 0.95 respectively. The Artefact-Net, when compared to InceptionV3, provided a better precision and F1 score in classifying clusters (Precision: 0.91 vs 0.80; F1: 0.91 vs 0.86). ConclusionThis study establishes a pipeline for SEC segmentation with the segmented component containing only single cells. The pipline will enable automated, cytology-based early detection with reduced bias.

Comparison Between Preoperative Inflammation Based Scores and TNM Staging in Patients with Oral Cancer

Abstract Background: India, one of the countries with the highest incidence of oral cancer, accounting for 30% of all new oral cancer cases in the world. Therefore, strong diagnostic markers are critical for the diagnosis and survival of patients suffering from oral cancer. Based on this relationship between inflammation and cancer progression, several inflammation-based scores have been demonstrated to have diagnostic and prognostic value in many types of malignant solid tumours. Objective: To compare the correlation between systemic inflammation based prognostic scores and tumour node metastasis (TNM) stage in patients undergoing oral cancer treatment. Methods: The inflammation-based scores were calculated for 120 patients with oral squamous cell carcinoma divided into four groups based on TNM staging. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), tumour size, nodes involved were analysed. Statistics were performed to compare the diagnostic value of the selected scores and TNM stage. Results: This current study compares 30 patients in each stage of TNM stages 1,2,3 and 4. The mean tumour size is 1.8 x 1.41, 3.23x2.28, 2.85x2.43 and 3.78x 3.06 in stage 1,2,3 and 4 respectively. The largest lymph node measurable was 1.33x1.36 in stage 3 and 1.84x 1.38 in stage 4. The number of lymph nodes involved in stage 3 are 1.1 and 2.82 in stage 4. The mean NLR in stage 1,2,3 and 4 were 2.68, 2.72, 3.17 and 3.68 respectively. The mean PLR in stage 1, 2,3 and 4 were 106.4, 117.8, 108.2 and 182.2 respectively. Conclusion: The present study indicates that elevated NLR and PLR values are associated with advanced stages of TNM staging for Oral squamous cell carcinoma.

Demographic, tumor and treatment factors of oral/oropharyngeal cancer in Alberta, Canada

<h3>Introduction</h3> Oral and oropharyngeal cancers have high morbidity and mortality worldwide. Distinct differ- ences exist between oropharyngeal and oral cancers; the former increasing in incidence and the later decreas- ing. The aim of this study was to determine demographic profiles, tumor characteristics and treatment factors of oral/oropharyngeal cancer in the adult population of Alberta, Canada. <h3>Methods/materials</h3> Information regarding oral/oropharyngeal cancer incidence in Alberta residents older than 18 years from 2005-2017 was extracted from the Alberta Cancer Registry database. Demographic factors included gen- der, diagnosis age, diagnosis date, age at death, vital status, death cause and geographic zone diagnosis. Tumor factors included location/site, morphology, histologic grade and clinical stage. Treatment modality was examined. Descriptive statistics was done using SPSS. <h3>Results</h3> 4069 oral/oropharyngeal cancer cases were identified. The mean (SD) age at diagnosis was 62.1 (13.3) years. 53.5% of diagnoses were made between 46-65 years of age, and 68.5% of patients were male. The number of reported oral cancer cases increased from 231 in 2005 to 398 in 2017. Most common cancer sites were tonsil (20%), tongue (19.1%), and base of tongue (15.8%). 78.6% of tumors were squamous cell carcinoma and variants and 39.1% of tumors were moderately-differentiated. 55.7% of cases were diagnosed at stage IV. Most common initial treatments were surgery (63.1%) and radiation (57.6%). As of 2017, 54.3% of patients in the study were reported alive. The main oral cancer-related deaths occurred in patients with tongue (13.9%), base of tongue (9.2%) and tonsil (9.1%) cancers. <h3>Conclusions</h3> There was a higher incidence of oral cancer in older males. Diagnoses were made at advanced stages. Higher mortality was associated with locations/sites that are difficult to examine. These findings are similar to other jurisdictions and support the need for early detection through screening examinations, increased awareness of oral/oropharyngeal cancer and earlier access to care.

CT Perfusion in Evaluation of Cervical Lymph Node Metastasis in Head and Neck Malignancies: A Cross-sectional Study

Introduction: Though, many cross-sectional modalities are available for evaluation of cervical lymph node metastasis but their results are highly variable. There is paucity of the literature in India, regarding lymph nodal assessment using Computed Tomography (CT) perfusion in head and neck malignancies even though, there is high incidence of oral cancer in India. Aim: To assess the role of Computed Tomography Perfusion (CTP) in evaluation of cervical lymph nodes in head and neck malignancies, by using CT perfusion parameters as compared to histopathology. Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis in collaboration with the Department of Surgery and Pathology at Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India, from October 2017 to April 2019. The study included 30 newly diagnosed head and neck cancer patients, with 46 nodes planned for surgical neck dissection. Computed tomography scan of neck was acquired using Siemens Somatom Definition Flash 256CT scanner. Reconstruction and post processing was performed on workstation and perfusion parameters were obtained to generate the CT perfusion maps. Differentiation between benign and malignant lymph nodes was done, on the basis of CT perfusion parameters such as Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT) and Permeability Surface (PS), which were compared with histopathological findings of resected lymph nodes. McNemar’s test was applied for comparison and statistical analysis. Receiver Operating Characteristic (ROC) curve of quantitative parameters were obtained, for the detection of sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPP) and diagnostic accuracy. Results: Out of 46 nodes, 23 were metastatic and 23 were non metastatic. The average value of BF in metastatic nodes was 174.61±71.76 mL/100g/min, BV was 16.32±11.9 mL/100g, MTT was 4.83±2.54 seconds and PS was 49.3±28.59 mL/100g/min. The average values for non metastatic nodes were: BF 88.06±34.4 mL/100g/min, BV: 9.89±7.63 mL/100g, MTT: 13.11±18.58 seconds and PS: 37.07±29.26 mL/100g/ min. The differences between the parameters like blood flow (p-value &lt;0.0001), blood volume (p-value=0.005) and MTT (p-value=0.002) in malignant and benign nodes were significant. In case of blood flow, sensitivity was 82.61% and diagnostic accuracy was 84.78%. In case of blood volume, sensitivity was 91.30% and diagnostic accuracy was 73.91%. In case of mean transit time, sensitivity was 56.52% and diagnostic accuracy was 73.91%. In case of permeability surface, sensitivity was 91.30% and diagnostic accuracy was 67.39%. Conclusion: Blood flow and blood volume values were significantly increased in metastatic cervical lymph nodes as compared to non metastatic nodes, whereas MTT was significantly low. Permeability surface showed equivocal results.

Trends of incidence, mortality, and disability-adjusted life years of oral cancer in Latin America.

To describe the trend in incidence, mortality and Disability Adjusted Life Years of oral cancer in Latin America according to sex between 2000 and 2020. This ecological study extracted oral cancer information from 20 Latin American countries from the GBD-2020 database. Oral cancer burden was described by age-standardized rate (ASR) of incidence, mortality, and DALYs. The data was compared according to sex and countries. Trends (Average Annual Percentage Change-AAPC) were estimated for each indicator, sex, and country between 2000 and 2020 using Joint-point software. Between 2000 and 2020, the highest incidence of oral cancer (ASR) occurred in Cuba (5.18), Brazil (4.38) and Uruguay (4.62). The countries with the highest mortality for both sexes were (ASR): Cuba (2.89), Brazil (2.71) and the Dominican Republic (2.58). The DALYs registered an average of 37.52 (Women: 22.39; Men: 52.62). The Dominican Republic reports increasing trends in incidence (AAPC: Men: 2.2; Women: 1.4), in mortality (AAPC: Men: 1.8; Women: 1.1), and in DALYs (AAPC: Men: 1.0; Women: 2.0). Costa Rica shows decreasing trends in men in incidence (AAPC: -1.3), mortality (AAPC: -1.6), and DALYs (AAPC: -1.8). Oral cancer shows increasing trends in: the incidence in both sexes in 10 countries, in mortality and DALYs in 6 countries, while the affectation between sexes does not show differences in trends.

Xerostomia - A Comprehensive Review with a Focus on Mid-Life Health.

Xerostomia is defined as the subjective complaint of a dry mouth. Xerostomia is common in menopausal women owing to the hormonal changes which take place during midlife. Studies show a higher incidence of oral cancer in the postmenopausal period which substantiates the theory of estrogen deficiency in carcinogenesis. Radiotherapy in the treatment of these cancers can lead to oral dryness. Other etiological factors of xerostomia include systemic diseases commonly occurring in middle-aged individuals and xerogenic drugs. Saliva plays a pivotal role in the maintenance of oropharyngeal health and xerostomia can severely impair the quality of life. The aim of this review was to provide vital information pertaining to the etiology, signs, diagnosis, and treatment of xerostomia with an emphasis on midlife health. The articles for this review were obtained from PubMed Central, Google Scholar, EBSCO, Science Direct, Medknow, Scopus, EMBASE, Web of Science, and authorized textbooks published between 1988 and 2021.

Cell Cycle Regulatory CCND1 G870A Gene Polymorphism and Periodontitis-Induced Oral Cancer: A Risk Analysis

Abstract Strong association has been recently observed between periodontitis/gingivitis and Oral squamous cell carcinoma (OSCC). A high incidence of oral cancer has been reported in the case of chronic periodontitis. Recently Cell cycle regulatory /Senescence genes have been associated with Gingivitis/ Periodontitis susceptibility. Cyclin D1 is one such cell cycle regulatory gene. Several findings have reported that Cyclin D1 (CCND1) G870A Single nucleotide polymorphism is associated with oral cancer (OC) risk, but yielded inconsistent data across different studies. This meta-analysis explores the precise relationship between CCND1 G870A polymorphism and OC risk. PubMed (Medline), EMBASE, &amp; Google Scholar databases were searched for eligible studies and pooled odds ratios (ORs) and 95% confidence intervals (CI) were calculated. Newcastle-Ottawa analysis was done for selected articles quality assessment, bias in publication (if any) was estimated through Funnel plots and Egger’s test. Pooled analysis from eleven eligible studies suggests that CCND1 G870A polymorphism is not significantly associated with OC risk. Sub-group analysis by ethnicity failed to show any association. Sequential single study omission was performed to determine the credibility and resilience of the inferences drawn.

Induction Chemotherapy Followed by Radiation Therapy Versus Surgery Followed by Concurrent Chemo-Radiation Therapy in Locally Advanced Squamous Cell Carcinoma of the Oral Cavity.

IntroductionSquamous cell carcinoma of the oral cavity is one of the top 10 malignancies reported globally. Pakistan has a high incidence of oral cancers due to the prevailing poor lifestyle habits/addictions of Pakistanis, and most patients with squamous cell carcinoma present with stage III or IV locally advanced disease. Recommended guidelines indicate surgery as the mainstay of treatment followed by radiotherapy (RT). The addition of induction chemotherapy before surgery or radiation therapy might improve outcomes with increased locoregional control rates.MethodsThis was a retrospective cohort study comparing the outcomes between surgery followed by concurrent chemoradiotherapy (CCRT) and induction chemotherapy followed by RT. This study primarily aimed to evaluate progression-free survival (PFS) and determine the toxicity of chemotherapy.ResultsWe found out that the mean PFS among patients undergoing surgery and CCRT and those receiving induction chemotherapy followed by RT were 6.40 (± 2.38) months and 7.6 (± 4.76) months, respectively.ConclusionInduction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil followed by RT shows satisfactory results with acceptable toxicity. However, the results are not statistically significant but support the already published data on this treatment aspect of oral cavity cancers.

Consequences of the COVID-19 Pandemic and Governmental Containment Policies on the Detection and Therapy of Oral Malignant Lesions-A Retrospective, Multicenter Cohort Study from Germany.

Simple SummaryDue to the COVID-19 pandemic, the oncology community was challenged with the need to protect a vulnerable population from a potentially fatal infection without jeopardizing cancer treatments. The impact of the crisis on the medical care of patients with oral cancer is largely unexplored. This multicenter cohort study from Germany aims to assess the consequences of the COVID-19 pandemic by comparing the healthcare of patients during the lockdown and post-lockdown periods in 2020 with the corresponding periods in 2018/19. We found the closure of dental practices during lockdown to possibly delay the diagnosis of oral cancer. Even if during this period no higher incidence of oral cancer was observed, data point to potentially fatal consequences for longer periods of treatment delay.(1) Background: In response to the global COVID-19 pandemic, governmental measures have been undertaken. The impact of the crisis on the healthcare of patients with cancer is largely unexplored. This multicenter cohort study aimed to investigate a potential screening delay and its consequences in patients with oral cancer (OC) during the pandemic. (2) Material and Methods: Data of patients who were first diagnosed with OC during different periods were collected, especially in terms of OC incidence, tumor stage/entity and time to intervention. The periods lockdown (LD) (13 March–16 June 2020), post-lockdown (PLD) (17 June–1 November 2020), and the corresponding equivalents in 2018/19 were differentiated and compared. (3) Results: There was no obvious trend towards a higher incidence of OC or higher tumor stages, whereas a trend towards a shorter time to intervention during the LD2020 could be observed. Subgroup analyses revealed an increased incidence in OC within the PLD2020 in Mainz, which might be explained by the partial closure of dental practices in this federal state during LD. (4) Conclusions: While there was no overall higher incidence of OC, we found closure of practices during LD to possibly delay cancer diagnosis. Therefore, measures must be taken to identify patients at risk and to ensure basic healthcare, especially in the context of dental screening measures.

Consumption pattern and genotoxic potential of various smokeless tobacco products in Assam, India: A public health concern

Smokeless tobacco (SLT) consumption is presumed to be one of the major causes of high incidence of oral cancer in India. The present study aimed to document various types of SLT products consumed and their potential impact on the genome instability on the population from Assam state in Northeast India. A cross-sectional study (n = 5000) showed that 60.56 % of the study population consumed at least one of the three forms (sadagura, zarda and khaini) of SLT of which 52.0 % were only sadagura users. Genotoxicity assessment using buccal cytome assay in 240 age and sex matched volunteers revealed that except for zarda, other forms of SLT induced significantly higher incidence micronuclei in the buccal epithelial cells compared to the control individuals. Similar effects were also observed in other cytome parameters related to cell proliferation, cytokinesis defects and cell death. Significantly higher incidence of micronucleus was observed among sadagura and khaini users in lymphocyte cytokinesis-blocked micronucleus assay. The addition of lime in sadagura increased the pH and anion levels which possibly result in higher absorption and may lead to the development of cellular anomalies.

Dysbiosis of Oral Microbiota During Oral Squamous Cell Carcinoma Development

Infection with specific pathogens and alterations in tissue commensal microbial composition are intricately associated with the development of many human cancers. Likewise, dysbiosis of oral microbiome was also shown to play critical role in the initiation as well as progression of oral cancer. However, there are no reports portraying changes in oral microbial community in the patients of Indian subcontinent, which has the highest incidence of oral cancer per year, globally. To establish the association of bacterial dysbiosis and oral squamous cell carcinoma (OSCC) among the Indian population, malignant lesions and anatomically matched adjacent normal tissues were obtained from fifty well-differentiated OSCC patients and analyzed using 16S rRNA V3-V4 amplicon based sequencing on the MiSeq platform. Interestingly, in contrast to the previous studies, a significantly lower bacterial diversity was observed in the malignant samples as compared to the normal counterpart. Overall our study identified Prevotella, Corynebacterium, Pseudomonas, Deinococcus and Noviherbaspirillum as significantly enriched genera, whereas genera including Actinomyces, Sutterella, Stenotrophomonas, Anoxybacillus, and Serratia were notably decreased in the OSCC lesions. Moreover, we demonstrated HPV-16 but not HPV-18 was significantly associated with the OSCC development. In future, with additional validation, this panel could directly be applied into clinical diagnostic and prognostic workflows for OSCC in Indian scenario.

Neurovascular Complications After Neck Dissection: a Prospective Analysis at a Tertiary Care Centre in South India

Owing to high incidence of oral cancers in India, neck dissection is the most commonly performed procedure in any head and neck oncology setup. This surgery is particularly prone to various neurovascular complications due to intricate anatomy of neck, but the exact incidence has been studied less especially in Indian subcontinent. A prospective observational study was done on 105 patients of oral cancer who underwent neck dissection at Regional Cancer Centre, Trivandrum, and various short-term and long-term neurovascular complications were recorded. There was high temporary praxia of marginal mandibular and greater auricular nerve of 32.5% and 36.1%, respectively, immediate post-operative period which reduced significantly during 6months. Eight patients had long-term shoulder abduction difficulty. There were isolated cases of IJV thrombosis and phrenic nerve paralysis. Despite our best intentions, complications arise due to complex anatomy of the neck, but if surgeon remains cognisant of the potential complications, their impact on patients' health, pocket and hospital resources can be minimized.

Clinicopathological Study of Biopsied Tongue Lesions Among 5284 Dental Outpatients in Southern Iran.

Some studies have shown a high incidence of oral cancer among tongue biopsy specimens. This study aimed to determine the prevalence and distribution of tongue biopsied lesions in an Iranian population. In this retrospective study, data from 5284 oral biopsy reports over a 22-year period (1996-2017) were evaluated regarding the type of lesions, location and patient's age and gender. Data were analyzed by descriptive analysis. Out of total oral lesions, 365 (6.9%) were tongue lesions, with the incidence peak (41.9%) in the age group of 41-60years old, with female tendency. Irritation fibroma, squamous cell carcinoma (SCC) and oral lichen planus (OLP) were the most common lesions. The lateral border of the tongue was the most common site of biopsy. Color changes, exophytic changes and ulceration were the most frequent reported clinical signs. The findings showed that tongue biopsied lesions had low frequency. Irritation fibroma, SCC and OLP were the most common lesions with a female predilection. By comparing the present results with other epidemiologic studies, it revealed valuable data, which can be useful for dental practitioners.

NOVEL USE OF FLUORESCEIN DYE IN DETECTION OF ORAL DYSPLASIA AND ORAL CANCER.

India is now regarded as the country with one of the highest incidence of oral cancer in the world. Considering poor survival in cases with late diagnosis, early detection can reduce morbidity and mortality of cancer patients and may impede malignant transformation in cases of oral potentially malignant disorders (OPMD). Most of the diagnostic aids are expensive and not available for mass screenings in developing countries. There is a need to develop a sensitive and affordable technique for screening of oral cancer, which can be accurate even in hands of health care workers with limited experience. Fluorescein dye has been used for tumour detection in colon, stomach, breast and brain. However, its utility in the diagnosis of oral cancer and OPMD has not yet been explored. This is the first study to report the role of fluorescein in the detection of oral cancer and OPMD. The present cross sectional study was conducted at a tertiary care dental centre. It included 100 individuals presenting with 42 OPMDs, 40 oral squamous cell carcinoma (OSCC) and 18 controls. The sensitivity and specificity for the fluorescein detection method for OPMDs and OSCC was found to be 96.6% and 52.4% respectively. The positive predictive value was 73.7% and the negative predictive value was 91.7% for the fluorescein method. The likelihood ratios stood at 2.03 for a positive test and 0.066 for a negative test. We conclude that fluorescein staining along with blue light is likely to improve detection of early oral cancers and dysplasia and can play a vital role in mass screening programmes of oral cancer.

Smoking and XPC Gene Polymorphism Interact to Modulate the Risk of Oral Cancer.

Oral cancer is the most common cancer among the Indian men and the second most common cancer among the Indian women. Such high incidence of oral cancer in India is due to consumption of tobacco in different form including smoking of cigarette. Smoke of tobacco contains different carcinogens which causes DNA damage. Such DNA damage if remain unrepaired due to faulty DNA repair system can cause mutation and eventual development of cancer. In the present study, we aimed to check the role of smoking as well as interaction of smoking and XPC polymorphism in risk modulation of oral cancer. Total of 372 subjects including 300 healthy controls and 72 patients of oral cancers been genotyped for the XPC PAT D/I, A/C and C/T polymorphisms with PCR based or PCR-RFLP based method. Genotype frequency was analyzed by chi-square test and strength of associations by odds ratio with 95% confidence intervals. The present study showed that compared to nonsmokers, smokers are at five times higher risk to develop oral cancer (p value= 0.001, OR= 5.03, 95% CI 2.91-8.69) and three times higher risk to develop node-positive (p value= 0.01, OR= 3.66, 95% CI 1.34-9.95) oral cancer. It has also been observed that individuals who were smokers and carrier of variant allele genotypes (AC and CC) for XPC A/C polymorphism were at threefold higher risk (p value= 0.01, OR=2.97, 95% CI 1.29-6.86) to develop oral cancer compared to individual who were smokers but do not carry the C allele (AA genotype). This observation indicates that C allele of XPC A/C polymorphism interacts with smoking and significantly increases the risk of oral cancer. This study demonstrates a possible role of smoking and gene-smoking interaction in risk enhancement of oral cancer.