Oral Potentially Malignant Disorders Research Articles

Immunoexpression profile of hypoxia-inducible factor (HIF) targets in potentially malignant and malignant oral lesions: a pilot study

Oral potentially malignant disorders (OPMD) are associated with an increased risk of oral squamous cell carcinoma (OSCC). OSCC has an aggressive profile and is the most prevalent among different head and neck malignancies. Most OSCC patients are diagnosed with advanced stage tumors and have a poor prognosis. Cancer cells are able to reprogram their metabolism, even in the presence of oxygen, enhancing the conversion of glucose to lactate via the glycolytic pathway, a phenomenon mainly regulated by hypoxia-inducible factor (HIF) signaling. Thus, several glycometabolism-related biomarkers are upregulated. Objectives This study aimed to evaluate the immunoexpression of the HIF targets GLUT1, GLUT3, HK2, PFKL, PKM2, pPDH, LDHA, MCT4, and CAIX in OPMD and OSCC samples, in order to identify potential correlations between biomarkers’ immunoexpression, clinicopathological features, and prognostic parameters. Methodology OSCC and OPMD samples from 21 and 34 patients (respectively) were retrospectively collected and stained for the different biomarkers by immunohistochemistry. Results CAIX and MCT4 expressions were significantly higher in OSCC samples when compared with OPMD samples, while the rest were also expressed by OPMD. GLUT3 and PKM2 alone, and the concomitant expression of more than four glycometabolism-related biomarkers were significantly correlated with the presence of dysplasia in OPMD. When considering OSCC cases, a trend toward increased expression of biomarkers and poor clinicopathological features was observed, and the differences regarding HK2, PFKL, LDHA and MCT4 expression were significant. Moreover, HK2 and CAIX were correlated with low survival rates. GLUT1 and GLUT3 were significantly associated with poor outcome when their expression was observed in the hypoxic region of malignant lesions. Conclusion OPMD and OSCC cells overexpress glycolysis-related proteins, which is associated with aggressive features and poor patient outcome. Further research is needed to deeply understand the glycolic phenotype in the process of oral carcinogenesis.

Active search screening for oral potentially malignant disorders and oral cancer in the city of Piracicaba.

Oral cancer is a public health problem worldwide with approximately 300,000 new cases diagnosed every year and more than 170,000 deaths annually. Squamous cell carcinoma (SCC) accounts for approximately 90% of all oral malignancies and it is frequently preceded by lesions known as oral potentially malignant disorders (OPMDs). Screening programs for early detection of oral lesions have been conducted. Therefore, the objective of this research was to carry out an active search in a screening program in the city of Piracicaba, Brazil. High-risk patients were identified at the city's health center through their medical records and referred for dental consultation. Other patients who opportunistically sought dental care were also seen and if they did not present risk factors for SCC, they were considered low-risk. A total of 756 patients were examined, and 445 met the criteria for the high-risk group and 311 for the low-risk group. It was possible to diagnose 27 OPMDs and six SCCs - 21 OPMDs and six SCCs occurred in high-risk patients and six OPMDs in low-risk patients. A chi-square test was applied and a statistically significant value (p = 0.006) was obtained for the detection of OPMD and SCC in patients of the high-risk group. Screening of high-risk patients through active search proved to be an effective program for diagnosing OPMD and SCC. Therefore, we encourage its implementation on a large scale to reduce the current scenario of this disease.

Evaluation of Salivary Interleukin-6 in Patients with Oral Squamous Cell Carcinoma, Oral Potentially Malignant Disorders, Chronic Periodontitis and in Healthy Controls - A Cross-Sectional Comparative Study.

Oral squamous cell carcinoma (OSCC) accounts for 95% among all head and neck cancers. Literature reveals saliva as a predictive, diagnostic and prognostic tool in carcinoma, inflammatory and genetic disorders. Expression of salivary interleukin-6 (IL-6) has been reported in patients with OSCC and in oral potentially malignant disorders (OPMDs). This study aims at the following objectives: • To evaluate the changes in the salivary levels of IL-6 in healthy individuals and those with chronic periodontitis (CP), OPMD and OSCC. • To compare the estimated levels of salivary IL-6 individually in healthy individuals and those with CP, OPMD and OSCC. • To assess the estimated levels of salivary IL-6 individually within histopathologically differentiated OSCC. • To analyse salivary IL-6 as a reliable biomarker in the diagnosis of OSCC. Totally, 60 patients were divided into four groups consisting of 15 patients in each group. Salivary samples were collected by simple drooling method. The concentration of IL-6 is to be determined by using Quantitative sandwich ELISA technique. All analyses were carried out using Statistical Package for Social Sciences (SPSS). The concentration values of IL-6 were found to be more in OSCC group in comparison with the other three groups and the concentration values of OPMD were found to be more than in the CP and control group and was statistically significant. We attempted a study to evaluate the salivary IL-6 in patients with OSCC, OPMDs and CP in comparison with the healthy controls. We achieved a pragmatic result showed that salivary IL-6 can be a reliable biomarker in the detection of OSCC. Saliva, due its wide array of functional characteristics, is an upcoming diagnostic fluid in the field of medicine and salivary IL-6 can be one such biomarker in the diagnosis of OSCC.

NLP and oral health information.

NLP and oral health information.

Assessment of DNA Ploidy in Oral Potentially Malignant Disorders Using a VELscope

Introduction: The device VELscope (Visually enhanced lesion scope) is intended as an aid to the clinician to complement a conventional white light exam (whether it be a general oral cavity examination or examination of a particular lesion) to detect abnormal tissue that might have otherwise been overlooked. In this study, it was used concomitantly with ploidy status to evaluate the malignancy potential of Oral Potentially Malignant Disorders (OPMD). Aim: To evaluate potential of Deoxyribonucleic Acid (DNA) ploidy as a preliminary adjunct to oral biopsy to identify patients with aneuploidy for the necessity of biopsy, and to assess the sensitivity of VELscope in the determination of accurate clinical parameters of the lesions in the oral mucosa. Materials and Methods: This in-vivo cross-sectional study was carried out in Department of Oral and Maxillofacial Pathology and Oral Microbiology, Bharati Vidyapeeth Deemed to be University, Pune from February 2020 to February 2021. Clinically diagnosed OPMD were included in the study, after verification of clinical extension boundaries by VELscope. DNA ploidy status was evaluated with DNA image cytometry and exclusive individuals with aneuploidy were biopsied followed by histopathological evaluation and surgical removal of the lesion. One way Analysis of Variance (ANOVA) test was used to compare the mean in 4 study groups [Oral leukoplakia, Oral submucous fibrosis, Oral lichen planus and Tobacco pouch keratosis] vs control. Sensitivity, specificity, positive predictive value and negative positive value was calculated by using the ROC (Receiver Operating Characteristic Curve) analysis. A p-value <0.05 was considered as significant for evaluating sensitivity of VELscope and evaluation of ploidy status. Results: The study included patients whose mean age was 45.8 years. The groups had tobacco habits in one of the various forms [smoke or smokeless] both in experimental and control group. VELscope could identify the clinical borders of the OPMDs considered via the loss of autofluorescence. Lesion borders were identified precisely with the loss of autofluorescence. It was quite helpful especially in aneuploid cases where the whole margin could be removed leaving no genetically aberrant cells behind. Oral submucous fibrosis was concluded to have maximal sensitivity of 86.7%, 100% in specificity and positive predictive and 88.2% negative predictive value. Conclusion: DNA ploidy could decipher the malignancy potential and could identify the individuals who needed biopsy. VELscope was able to mark the clinical diameters which were not visible to naked eyes clinically. Oral submucous fibrosis was found to be group with the maximum potential of malignancy followed by Oral Lichen Planus, Oral Leukoplakia and Tobacco Pouch Keratosis.

WBC & THEIR ROLE IN TUMOR MICROENVIRONMENT (TME) OF ORAL SQUAMOUS CELL CARCINOMA-A REVIEW

Oral premalignant lesions (OPLs) that affect approximately 4.5% of the world's population usually precede the occurrence of Oral squamous cell carcinoma. These lesions are now included in oral potentially malignant disorders (OPMD). Majority of OPLs regress, yet, up to 30% of them ultimately progress through increasingly grades of dysplasia &culminate as oral cancer. Therefore, OPLs represent an intermediate phase during the evolution of normal mucosa into malignant tumor, owing to their acquisition of a subset of the genomic alterations from those necessary to develop into Oral Squamous cell Carcinoma(OSCC).(1) In India OSCC is responsible for more than 20% of new malignancies diagnosed every year, being the most prevalent malignancy in the nation. There are several prognostic factors which help to evaluate the risk associated with the OSCC and serve as subsequent treatment guidelines. Increasing evidence has, so far, suggested that inammation may be linked to pathogenesis of oral cancer. Also, the tumor microenvironment is considered a crucial component in the understanding of the biologic behavior of a neoplasm. Leukocytosis is common in patients with progressive oral squamous cell carcinoma, is related with T-classication, lympho-vascular permeation, and recurrence or metastasis, &, therefore could decrease survival. Tumor-related leukocytosis results from hematopoietic colony-stimulating factors and inammatory cytokines from solid tumors. (2,4) One of the new most promising histopathological factor in prognostic evaluation of OSCC is, the density of tumour inltrating lymphocytes (TILs). Different subsets of lymphocytes have different or even opposing functions in the tumor microenvironment. (2,6,7) Neutrophils contribute to cancer progression or regression via multiple mechanisms, including the suppression of cytotoxic as well as helper Tcell responses and the stimulation of tumor angiogenesis.(8) B cells also act as antigen-presenting cells, promote differentiation of Th1 cells and Tcyt cells, and directly kill cancer cells through release of Granzyme B, thus, having a tumor suppressive role. (9) Inltrating eosinophils in the tumor microenvironment (TME), supply direct and indirect mitogenic growth mediators that stimulate proliferation of neoplastic cells, as well as educate other stromal cell types to induce paracrine and juxtacrine mitogenic signaling molecules to support neoplastic growth which also appears true for oral squamous cell carcinomas (OSCCs). (10) The plasmacytoid dendritic cells (pDC), are specically important in cancer immunity as, these cells have been identied in many solid malignant tumors, including those of head and neck & may play a key role in tumor occurrence and development.(9,12) Mast cells have a long life and form a heterogeneous population of cells that seem to have both a positive and negative regulatory effect on the immune system. MCs accumulate into tumor microenvironment by the help of tumor cell-released chemoattractants such as SCF or CCL15 and actively recruit cells of the innate immune system mainly neutrophils, macrophages, and eosinophils and cells of the acquired immune system (B and T cells) to orchestrate antitumor immune responses (13) In cancer tissues, the inltration of macrophages is signicantly increased. Macrophages are recruited to this edge by tumor-derived chemotactic agents and are a major inltrating cell type in the leading edge of a carcinoma.(16) OSCC are highly immunogenic tumors that are often characterized by abundant inltration of immune cells, however, their function & prognostic value vary. (19, 20)

Is oral lichen planus a potentially malignant disorder?: A critical appraisal; a commentary on the letter to the editor.

Is oral lichen planus a potentially malignant disorder?: A critical appraisal; a commentary on the letter to the editor.

Integrating Cutting-Edge Methods to Oral Cancer Screening, Analysis, and Prognosis.

Oral cancer (OC) has become a significant barrier to health worldwide due to its high morbidity and mortality rates. OC is among the most prevalent types of cancer that affect the head and neck region, and the overall survival rate at 5 years is still around 50%. Moreover, it is a multifactorial malignancy instigated by genetic and epigenetic variabilities, and molecular heterogeneity makes it a complex malignancy. Oral potentially malignant disorders (OPMDs) are often the first warning signs of OC, although it is challenging to predict which cases will develop into malignancies. Visual oral examination and histological examination are still the standard initial steps in diagnosing oral lesions; however, these approaches have limitations that might lead to late diagnosis of OC or missed diagnosis of OPMDs in high-risk individuals. The objective of this review is to present a comprehensive overview of the currently used novel techniques viz., liquid biopsy, next-generation sequencing (NGS), microarray, nanotechnology, lab-on-a-chip (LOC) or microfluidics, and artificial intelligence (AI) for the clinical diagnostics and management of this malignancy. The potential of these novel techniques in expanding OC diagnostics and clinical management is also reviewed.

A novel approach in diagnosis and treatment of oral cancer

Oral squamous cell carcinoma (OSCC) is a group of highly malignant tumors that may arise from the surface epithelium or minor salivary glands. Approximately 85% to 95% of all oral cancer is squamous cell carcinoma (OSCC) which is a very aggressive cancer, representing one of the most common malignancies worldwide. Oral potentially malignant disorders (OPMDs) regroup a variegate set of different histological lesions, characterized by the potential capacity to transform in OSCC. The conventional treatment modalities of oral cancer include surgical excision, radiation therapy, chemotherapy, or a combination of these approaches. These traditional methods may not use effectively due to their poor bioavailability. Hence, reformulation of drugs or improved drug delivery may enhance bioavailability. Targeted therapy is a novel approach to deliver drugs to specific cells, organs, cell organelles to improve the collection of the delivered active components in the desired site of action and decrease the side effects and systematic toxicity that accompanied conventional therapy. Nanodentistry uses nanotechnological approaches with a particle size of 10-9 meters including nondiagnostic, nanoparticles, and nanodrugs for diagnosing, treatment, and prevention of oral and dental diseases to improve dental health. This review describes different nanoparticles accompanied by therapeutic agents for effective and useful diagnosis and treatment of oral cancer.

Assessment of brush biopsy findings and salivary LDH levels in oral mucosal lesions of tobacco users.

The oral brush cytology is an alternative method developed to improve the efficacy of conventional cytology in oral potentially malignant disorder (OPMD), and salivary lactate dehydrogenase (LDH) which is a cytoplasmic enzyme has been widely used as a marker for diagnosing various diseases. The purpose of the study is to evaluate the brush biopsy findings and salivary LDH levels for the early diagnosis of premalignant and malignant lesions of the oral cavity. Patients with deleterious habits including tobacco-related lesions such as leukoplakia, tobacco pouch keratosis, and oral cancer were included in the study. For each patient, saliva sample was collected, brush biopsy was done and smears were prepared. Collected saliva samples were analysed for salivary LDH levels and prepared smears were analysed for dysplastic changes and statistical analysis was performed. Out of 80 samples, 30 were leukoplakia, 45 were tobacco pouch keratosis and 5 were oral cancer, and 13 samples showed positive dysplastic changes, 26 samples showed atypical dysplastic changes and 41 samples showed no signs of dysplastic changes and concluded as negative. On comparing the results of brush biopsy findings and salivary LDH levels, the mean salivary LDH value for positive dysplasia was elevated and the P value was statistically significant (P value: 0.00). Brush biopsy showed good potential in detecting premalignant lesions and salivary LDH levels showed a marked increase which can be used as a diagnostic biomarker and serve as a potent diagnostic aid for early detection of malignancy.

Salivary miRNAs Expression in Potentially Malignant Disorders of the Oral Mucosa and Oral Squamous Cell Carcinoma: A Pilot Study on miR-21, miR-27b, and miR-181b

(1) Background: Oral potentially malignant disorders (OPMD) represent a fundamental challenge for clinicians, considering the possibility of progression into oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Several studies have examined the expression of miRNAs in humans as diagnostic and prognostic biomarkers. Among these, miR-21, miR-27b, and miR-181b proved to be promising. This cohort study evaluated the different expressions of those miRNAs in the saliva of patients with OPMD and OSCC. (2) Methods: Patients with a clinical diagnosis of OPMD and/or OSCC were enrolled; saliva samples were collected; miRNAs were extracted and quantified via qRT-PCR was performed. Data were analyzed by subgroups based on the histopathological diagnosis (OSCC and the grade of OED) using the ΔΔCt method. Saliva from 10 healthy donors was used as the control. One-way ANOVA and Kruskal-Wallis tests were performed to assess the differences between groups. (3) Results: 23 patients for the OPMD group (6 with no dysplasia, 7 with low-grade, and 10 with high-grade dysplasia) and 10 with OSCC were analyzed. MiR-21 did not show any variation among groups; miR-27b was under-expressed in dysplastic lesions (p = 0.046); miR-181b was upregulated in high-grade dysplasia (p = 0.006), increasing with the degree of dysplasia, and decreasing in OSCCs. (4) Conclusions: Salivary miR-27b and miR-181b could be promising biomarkers for oral dysplasia. Further studies are needed to clarify their feasibility.

The use of autofluorescence for screening and early detection of oral potentially malignant disorders – A narrative review

Premalignant lesions of the oral cavity encompass a broad range of pathology and are often comorbid in a variety of patient populations. Prompt diagnosis and management of these lesions are essential to prevent patient morbidity and mortality. The purpose of this article is to summarize and review the evaluation, screening and early detection of premalignant lesions of the oral cavity and to highlight the role of the dental team in recognizing and treating patients with these conditions, that may progress to oral cancer. In addition, a review of a non-invasive detection technique that is currently being marketed to aid general dentists and other healthcare providers for early diagnosis of potential cancerous lesions is presented. Although many studies have assessed the diagnostic accuracy of autofluorescence in oral potentially malignant disorders (OPMDs), there has been a paucity of such information in high-risk populations.

Aldehyde dehydrogenase 1: Its key role in cell physiology and oral carcinogenesis.

Aldehyde dehydrogenase (ALDH), an aldehyde-metabolizing enzyme, is a cytosolic antioxidant. It performs many important physiological catalytic and non-catalytic functions in mammalian cells. Apart from physiological functions, like the biosynthesis of vital molecules, this NAD(P)+ substrate-dependent enzyme superfamily is primarily involved in catalyzing the oxidation of highly reactive exogenous and endogenous aldehydes to their respective carboxylic acids. Among ALDH isoenzymes, ALDH1 has gained much attention as a prominent stem cell marker, as it is associated with the maintenance of stemness and the differentiation of normal stem cells, in addition to involvement in oncogenic functions, like cell proliferation, anti-apoptosis and the reduction of oxidative stress in cancer stem cells (CSCs). In this context, the authors review the physiological functions of ALDH1 in normal cells, normal stem cells and CSCs, along with the discussion of the putative role of ALDH1 in oral carcinogenesis by commenting on its expression in normal oral mucosa cells, oral potentially malignant disorders (OPMDs), like leukoplakia and dysplastic lesions, and oral squamous cell carcinoma (OSCC).

Gambaran pengetahuan dan sikap dokter gigi di indonesia mengenai opmd (Laporan Penelitian)

Background: Oral cancer is one of the most causes of morbidity and mortality due to malignancy in Indonesia. This problem usually occurs because the cancer is found late in its development. Oral Potentially Malignant Disorders (OPMD) can be detected and treated as early as possible to prevent their transformation into oral cancer by dentists with a good knowledge and attitude about OPMD. Aim: To describe the knowledge and attitudes of dentists in Indonesia regarding OPMD. Method: Descriptive observational study with a cross-sectional design using an online questionnaire (google form) consisting of 47 questions about knowledge and attitude to 167 dentists in Indonesia. The knowledge was categorized into high, moderate, and low levels. The attitude was categorized into good, moderate, and low levels. Results: This study collects data from 167 people according to the inclusion criteria, consisting of 124 women and 43 men, of whom were aged 20-29 years (58 people), 30-49 years (97 people), and >50 years (12 people). A total of 121 respondents have a high level of knowledge and 46 respondents in the moderate category meanwhile, 124 respondents have good attitude categories, 42 respondents in the moderate categories, and one respondent in the low one. Conclusion: The dentist in Indonesia has a high level of knowledge with an average score of 18.86+0.23 and a good level of attitude with an average score of 15+0.18.

Gambaran pengetahuan dan sikap mahasiswa kedokteran gigi di indonesia mengenai OPMD (Laporan Penelitian)

Background: Oral cancer in Indonesia still has a fairly high prevalence. The appearance of oral cancer can be initiated by the presence of Oral Potentially Malignant Disorder (OPMD) lesions, which is a disorder that may become a malignancy with a condition that is often preceded by the development of cancer of the lips and oral cavity. The knowledge and attitudes of dental education students regarding OPMD need to be achieved well so that it can be applied when practicing as a dentist. Objective: To describe the knowledge and attitudes of dental students in Indonesia regarding Oral Potentially Malignant Disorder. Method: This is a descriptive observational study with a cross-sectional design. The research was conducted by distributing an online questionnaire through a google form consisting of 47 questions about knowledge and attitudes to 211 clinical dental students faculty of dentistry in Indonesia. Respondents are classified into three levels based on their responses to the questionnaire, such as high, medium, and low. Results: A total of 211 respondents were 83.4% female and 16.6% male, of whom were aged ≤ 21 years old (16.6%), 22 – 24 years old (60.2%) and ≥ 25 years old (23.2%). A total of 125 subjects (59.2%) had high knowledge category and 86 subjects (40.8%) had a moderate category. Meanwhile, 195 subjects (92.4%) had attitudes in the good category, 13 subjects (6.2%) in the moderate category and 3 subjects (1.4%) in the poor category. Conclusion: The knowledge of OPMD among dental students in Indonesia were high with scores of 18.45 + 0.21, whereas the attitudes were good with scores of 17.10 + 0.17.

Prognostic Potential of Argyrophillic Nucleolar Organizer Regions (Agnors) in Oral Lesions: A Systematic Review

Early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is important for dental professionals to improve patient survival rates. More than half of patients with oral squamous cell cancer had advanced disease at the time of diagnosis, indicating a lack of early detection and risk assessment biomarkers. The development of new protein biomarkers will help in early diagnosis and treatment.The argyrophilic nucleolar organiser regions (AgNORs) staining technique is simple and cost-effective. These are replicatory markers that identify epithelial dysplasia. And it also plays a very important role in differentiating the benign, pre-malignant, and malignant lesions of the oral cavity. The number of AgNORs per cell has been considered an indicator of cellular proliferative activity. Microscopically, NORs can be identified as well-defined black dots located throughout the cell nucleus. The agNOR quantity is strictly proportional to the proliferative activity of the cell. AgNOR quantification helps in the determination of the degree of epithelial dysplasia and, consequently, in the analysis of its potential for malignant transformation. AgNOR qualitative characteristics help in differentiating hyperplastic, premalignant, and malignant oral lesions. The sliver staining technique is useful for studying the structure of the nucleolus as well as the variations in its activity. AgNORs are a valuable parameter in tumour pathology.

Histopathological and risk factor analyses of oral potentially malignant disorders and oral cancer in a proactive screening in northeastern Thailand

BackgroundLip and oral cavity cancer has been reported as the 10th most common cancer in Thailand. Recently, a screening program for oral potentially malignant disorders (OPMDs) and oral cancer was conducted in the northeastern Thailand which took into consideration a total of 371,911 people who resided in the provinces of Buriram, Chaiyaphum, Nakhon Ratchasima, and Surin.MethodsA total of 330,914 subjects were consecutively screened for risk factors of oral cancer by village health volunteers (VHVs) using a questionnaire (S1). Then, 186,710 subjects with one or more risk factors for oral cancer were referred for oral screening by dental auxiliaries or dentists at sub-district level hospitals (S2) where 86,941 subjects were subsequently screened. Afterwards, 1576 subjects with suspicious oral lesions for OPMDs or oral cancer attended local hospitals for further investigation and treatment. Oral medicine specialists, oral surgeons, and local dentists at the district level hospitals performed biopsies and the samples were sent for histopathological analysis. The objectives of the study were to report the histopathology findings from the biopsies obtained from these subjects and the associated risk factors.ResultsOut of 427 subjects who received biopsies, complete diagnostic results were obtained from 409 patients (462 specimens). The 5 most common histopathological results from these specimens were mild epithelial dysplasia (27.3%), fibroepithelial hyperplasia (14.5%), oral lichen planus/oral lichenoid reactions (11.5%), moderate epithelial dysplasia (8%), and acanthosis with or without hyperkeratosis (5%). Oral squamous cell carcinoma was detected in 14 subjects and 11 other forms of oral cancer were revealed. Among the analyzed risk factors, habitual betel quid chewing was established as a statistically significant risk factor associated with OPMDs and oral cancer.ConclusionThe most frequently observed histopathological results of clinically suspected oral cancer and OPMDs included mild epithelial dysplasia, fibroepithelial hyperplasia, oral lichen planus/oral lichenoid reactions, moderate epithelial dysplasia, and acanthosis with or without hyperkeratosis. Betel quid chewing habit was found to be associated with OPMDs and oral cancer.

Testing the accuracy of autofluorescence device in diagnosing oral potentially malignant disorders among people with HIV seeking dental care.

Although many studies have assessed the diagnostic accuracy of autofluorescence in oral potentially malignant disorders (OPMDs), there has been a paucity of such information in high-risk populations. Our study thereby tested the accuracy of using autofluorescence in the oral examination of suspicious lesions among patients seeking care at an HIV-specialized dental clinic in Houston, Texas. We performed a prospective single-arm design in which forty-four (44) HIV-infected individuals seeking dental care at a specialized-HIV dental clinic were recruited. Each subject had their oral cavity examined under conventional lighting and then used a fluorescence light-based handheld device (OralID®). Biopsy was obtained from unresolved suspicious OPMDs at the 15-day follow-up, and histopathological analysis was conducted. The oral lesions, not the patient, were treated as the unit of analysis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using SPSS. The results showed that OPMDs could be identified with a sensitivity of 90%, a specificity of 18%, an NPV of 86%, a PPV of 24% using the fluorescence light-based handheld device, with a diagnostic accuracy of 55%. Despite the low specificity, fluorescence light can complement clinical oral cancer screening and aid identification of OPMDs during biopsy procedures. Our findings suggest that autofluorescence devices could supplement clinical oral examination and aid the identification of OPMDs during biopsy procedures, potentially improving oral cancer screening among HIV-positive patients seeking care.

Prevalence of oral potentially malignant disorders (OPMD) in adults of Western Maharashtra, India: A cross-sectional study.

Oral cavity cancer is estimated to be the third most common malignancy after cancer of cervix and stomach in developing countries. The objective of this study is to investigate the relationship between smoking, alcoholic consumption, betel quid chewing, and OPMD in a prospective manner. A descriptive, cross-sectional study was conducted among 35-55-year-old adults of Western Maharashtra, India. Oral cavity examination as recommended by the American Dental Association specification was followed. Data recorded were transferred from precoded survey pro forma to the computer. The prevalence of OPMD was assessed by determining the percentage of the study population affected. Analysis was done to find out the risk of oral premalignant disorders. The Chi-square (x2) test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated. The Statistical Package for the Social Sciences (SPSS) software version 21.0 was used for the statistical analysis and significance level was set at P < 0.05. Odds of having OPMD are five times higher for those who smoke (OR = 5.78; 95% CI, [6.18, 7.82]) as compared to those who do not. The odds of suffering from OPMD are about five times higher among those who chew as compared to those who do not (OR = 4.98; 95%CI, [2.91, 7.28]). The mean frequency of tobacco chewing per day and duration in years in participants with OPMDs was significantly higher as compared with normal oral mucosa (P < 0.05 and P < 0.05), respectively, in the use of different tobacco forms. These findings can be used to design case control or cohort studies to further understand the relation between habits and OPMD.

Comparison of PD-L1 Expression in Oral Squamous Cell Carcinoma and Premalignant Lesions of Oral Cavity

Objectives of this study were to compare expression of Programmed Death-Ligand 1(PD-L1) protein in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorder (OPMD) cases; and to compare the PD-L1 protein expression in histological grades of OSCC and also in OPMD's with Dysplasia and without Dysplasia. In this study, 25 cases of Oral squamous cell carcinoms, 25 cases of Oral Potentially Malignant Disorders and 10 cases of non-neoplastic oral mucosa (control) cases were included. FFPE blocks of OSCC and OPMD cases were contributed by Department of Pathology, Histopathology Division,Pakistan Institute of Medical Sciences, Islamabad. Immunohistochemical staining of cases with PD-L1 monoclonal antibody (1:100; Dako) was carried out at Histopathology division , PMC Labs, Peshawar Medical College,Peshawar, Riphah International University, Islamabad . Epithelial cells (membranous and cytoplasmic) positivity was observed for PD-L1 Antibody. Data was analyzed in SPSS version20. For qualitative variables frequencies and percentages were calculated whereas for quantitative variables means and standard deviations were recorded. The Chi-square test was applied to evaluate the significant difference in categorical variables . p-value of ≤0.05 was taken as significant. PD-L1 expression in OSCC cases turned out to be 48% (n=12/25) as compared to 8% of OPMD cases (n=2/25) with a significant p value of 0.002 and all non-neoplastic oral mucosa cases were negative. PD-L1 expression in high grade OSCC cases was quite high (61% n=11/18) as compared to low grade OSCC (14% n=1/7) cases with a significant p value of 0.035. A statistically significant increased PD-L1 expression was noted in OSCC as compared to OPMD. Expression of PD-L1 was more intense in high grade OSCC cases. The relation of PD-L1 expression to age ,gender or location of OSCC and OPMD cases , and presence of dysplasia in OPMD cases was statistically not significant.