Oral Submucous Fibrosis Group Research Articles

Evaluation of Candidal Species in Oral Submucous Fibrosis and Oral Lichen Planus: A Microbiological Study

Background: Candida is opportunistic microorganisms in oral cavity, causes oral candidiasis. The presence of candida and subspecies in oral premalignant lesions may intensify the infection and transform pre malignant lesions into cancer. Objective: To isolate various types of candida species, among Oral submucous fibrosis (OSMF) and Oral lichen Planus (OLP) patients. Methodology: Total 60 individuals included and grouped as; OSMF (n=20) group A, Lichen Planus (n=10); group B and Controls (n=30) group C. Results: The higher candida carriage revealed in OSMF+ OLP groups (23.3%) as compared to controls (10%). The species level findings showed 13.3% of candida albicans in OSMF+ OLP and 6.7% in controls, candida krusei 6.7% in OSMF+ OLP and 3.3% in controls and non candida albicans were 10% in OSMF+ OLP and 6.7% in control group respectively. Conclusion: This basic understanding of candida species and their association with potentially malignant disorders will help in better interventions, so as to restrict the lesion before it transform in to malignancy.

Electromyography Analysis of the Masseter Muscle's Activity in the Management of Oral Submucous Fibrosis.

Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the oral mucosa with a higher malignant potential rate for oral cancer. This study aimed to analyze the utility of electromyography (EMG) as the prognostic assessment tool in the management of OSMF with conventional intralesional corticosteroid therapy. Materials and methods This study included 20 OSMF cases of age range 20 to 80 years without systemic comorbidities to assess pre-treatment and post-treatment changes with intralesional corticosteroid therapy as an intervention and to determine if it could be assessed using electromyographic study. Clinical and histopathological grading of OSMF was done. The five clinical parameters were evaluated for measuring treatment prognosis. Among them, mouth opening, tongue protrusion, and burning sensation assessments were quantitative parameters, and palpable fibrotic bands and mucosa colour were qualitative parameters. As OSMF involves changes in muscle plane in moderately advanced and advanced cases, EMG was used as an assessment tool for measuring muscle activity. Among the muscles of mastication, the masseterand temporalis were selected for evaluation. Twenty age and gender-matched healthy controls were required for this study as there are no standardized normal values for amplitude and onset of activity in muscle analysis. The EMG activity of the right and left temporalis and masseter muscles were recorded using surface electrodes and were correlated with five clinical assessment parameters. Results In the right masseter, the rest amplitude of 1.6010 µV of the OSMFwas statistically significant (p-value: 0.050) when compared with 4.1275 µV of the control. The clench amplitude of 133.370 µV of the OSMFwas statistically significant (p-value: 0.062) when compared with 94.310 µV of the control. In the left masseter, the rest amplitude of 1.6695 µV of the OSMFwas statistically significant (p-value 0.066) when compared with 2.5735 µV of the control. In the left masseter, the onset of muscle action of 62.670 ms of the OSMFwas statistically significant (p-value: 0.017) when compared with 131.835 ms of the control. The clench amplitude differences in the right masseter of 133.370 µV pre-treatment, and 102.775 µV post-treatment were statistically significant (p-value: 0.007). The clench amplitude in the left masseter of 102.535 µV pre-treatment, and 92.090 µV post-treatment were statistically significant (p-value: 0.036). The correlation was seen between tongue protrusion and rest amplitude in the right masseter in OSMF (r = 0.376, p-value: 0.023). Conclusion There was a correlation between tongue protrusion and rest amplitude in the right masseter muscle in OSMF patients before treatment. In the right and left masseter, during rest, the amplitude of the OSMF group was lesser than that of the control group. During clench, in the right masseter, the amplitude of the OSMF group was higher than that of the control group. During clench in the left masseter, the onset of muscle action was lesser in the OSMF group than in the control group. After treatment, there was a reduction in clench amplitude in OSMF patients from their pretreatment values signifying muscle relaxation and a better onset of muscle action.

Evaluation of salivary tumor necrosis factor α as a diagnostic biomarker in oral submucosal fibrosis and squamous cell carcinoma of the oral cavity and oropharynx: a cross sectional observational study.

Tumor necrosis factor α (TNF-α) is known to be associated with chronic inflammation, and its expression has been shown to increase in advanced cancers. Chronic inflammation is a characteristic feature of oral submucous fibrosis (OSMF), which is a potentially malignant disorder (PMD). Squamous cell carcinoma (SCC) is associated with considerable mortality and morbidity and an early detection or monitoring would greatly help in achieving an effective cure. TNF-α was thus evaluated for use as a biomarker in the present study according to the stage of OSMF and histological grade of SCC in the oral cavity and oropharynx. This study included 45 patients divided into 3 groups-OSMF group, SCC group and control group-each comprising 15 participants. Saliva samples were collected from each patient, and salivary TNF-α levels were estimated using an ELISA kit. Statistical analysis revealed no significant differences in TNF-α levels among the OSMF, SCC and control groups; however, there was an increase in the salivary TNF-α level in patients with stage 3 disease according to the clinical stage of OSMF, for which the p value was 0.027. An increase in the TNF-α concentration with increasing clinical stage suggested a role for TNF-α in the spread of OSMF involvement in anatomical structures of the oral cavity and oropharynx. No significant difference in salivary TNF-α levels was noted among the OSMF, SCC and control groups. The study showed a positive correlation of TNF-α with increasing stages of OSMF but was not a reliable biomarker in the categorization of the same.

Salivary Levels of Hypoxia Inducible Factor-1α in Stage III Oral Submucous Fibrosis: A Comparative Clinical and Laboratory Study

Background: A persistent, crippling disease known as oral submucous fibrosis (OSMF) is distinguished by fibrosis of the juxta-epithelium. It has been proposed that betel quid chewing and its malignant transformation of OSMF are associated with hypoxia, a major micro-environmental component in OSMF. The primary regulator of hypoxia in cellular response, HIF-1α is significantly up-regulated in several fibrotic disorders, including OSMF. Objective: The objective of this study was to examine the expression of the protein HIF-1α in the salivary samples of healthy controls and stage III OSMF. Methods: It was a case-control study carried out in the Department of Oral Medicine, Ziauddin University, Karachi from July 2020 to May 2021. There were 57 participants in the present study, 29 healthy controls and 28 patients with stage III OSMF. The method of non-probability consecutive sampling was employed. Demographic information was gathered using a standardized baseline questionnaire. The enzyme-linked immunosorbent assay was used to measure the amount of HIF-1α present in saliva. To find out if the data was distributed normally, the Shapiro-Wilk test was performed. To compare the expression of HIF-1α protein between the two study groups, the Mann-Whitney test was used. Results: In the stage III OSMF group, the mean salivary HIF-1α value was 25.64±1.27 ng/ml, while in the control group, it was 12.30 ± 1.58 ng/ml. The Mann-Whitney U-test revealed a statistically significant difference (p< 0.001). A significant negative correlation (r = -0.526, p = 0.000) was seen in the individual group analysis between salivary HIF-1α and mouth opening. Conclusion: In comparison to the healthy individuals, the stage III OSMF group had higher levels of HIF-1α protein. The results of our investigation suggest that HIF-1α could be a valuable marker of malignant transformation in OSMF.

Evaluation of dermatoglyphics patterns as predisposition factor for occurrence of oral submucous fibrosis: A hospital-based case–control study

Background: One of the key factors in the prevention of the disease is the identification of the risk factors early in life. Based on multifactorial causation of oral submucous fibrosis (OSMF), apart from habit history, the genetical predisposition may be considered as an important risk factor in the occurrence of OSMF disease. The dermatoglyphic pattern may prove a salient genetic marker for the determination of OSMF as both are having similar intrauterine development period. Objectives: To find out and compare the association between dermatoglyphics and OSMF. Materials and Methods: The present study was conducted on total 108 subjects divided in three groups where Group A was subjects with OSMF, Group B was subjects with tobacco related habits but without OSMF, and Group C was healthy controls. Fingerprint patterns of both hands were recorded and classified into whorls, loops and arches. Results: The loop pattern was significantly higher in subjects having OSMF (Group A) as compared Group B and Group C in general as well as for left and right hands. The maximum prominence of loop patterns was noted in the little finger among the subjects with OSMF. Results for subjects with OSMF and without OSMF under five years of having tobacco chewing habits had also clearly demonstrated prominence of loop patterns in the subjects with OSMF. Conclusion: The results of our study show that there is a staunch possibility of genetically determined factors in the form of loop finger prints can be responsible for the occurrence of OSMF.

The expression of Th17/Treg in oral submucosal fibrosis carcinogenesis and the significance in the development of mucosal lesions.

It targets to explore the expression of Th17/Treg in oral submucous fibrosis (OSF) carcinogenesis and its significance in the development of mucosal lesions. In this research, 100 patients with OSF who visited our hospital for surgical treatment from March 2020 to April 2022 were selected. Based on pathological examination results, the patients were divided into 27 patients with oral leukoplakia (OK) group, 14 patients with oral lichen planus (OLP) group, 9 patients with oral squamous cell carcinoma (OSCC) group, and 50 patients with OSF group. It adopted flow cytometry (FC) to calculate the ratio of peripheral blood Th17 cells and Treg cells in four groups, and the Th17/Treg ratio was calculated; The area of oral mucosal lesions (OML) from patients was collected. It needs to compare the differences in Th17/Treg ratio and OML area among four groups and determine the correlation between indicators. ROC curve was used to analyze the diagnostic threshold of the Th17/Treg ratio for carcinogenesis. Except for the OK and OLP, it had statistical significance differences in Th17, Treg cells, and Th17/Treg ratio (P<0.001); The area of OML in the OK, OLP, and OSCC was higher than that in the simple OSF, with statistical significance (P<0.001); Th17 (%), Treg (%), and Th17/Treg all had direct ratio with the area of OML; The area of OML has directed ratio with the development of mucosal lesions (r>0, P<0.05); The areas under the ROC curve for patients with OSF combined with OK, OLP, or OSCC with Th17 (%), Treg (%), Th17/Treg, and OML area were 0.560, 0.986, 0.936, and 0.466, respectively. The expression of Th17/Treg is elevated in oral submucosal fibrosis and carcinogenesis. When mucosal lesions progress or become cancerous, the Th17/Treg ratio increases accordingly, and it has more clinical value than the increase in the OML area.

Study of Oral Squamous Cell Carcinoma with and without Oral Submucous Fibrosis.

Oral submucous fibrosis (OSMF) is a precancerous condition associated with areca nut chewing. Arecoline which isa component of areca nut is considered a carcinogen. The OSMF in patients with oral squamous cell carcinoma (OSCC) indicatesareca nut-induced carcinogenesis. The molecular pathway for oral carcinogenesis caused by areca nut is discrete and considereda different clinicopathological entity. Thus the present study aims to study and compare the demographics, risk factors, and clinicalcharacteristics of OSCC patients with and without OSMF. It was a retrospective study done by medical record review. About 40OSCC cases were selected, of which 20 were with OSMF, and 20 were without OSMF. Demographic data, risk factors includinghistory of habits such as areca nut chewing, tobacco, etc., and clinical characteristics such as anatomical location, extent, tumorsize, and lymph node metastasis were noted, and data were analyzed. The mean age of OSCC cases with OSMF was younger thanthose without OSMF. The study groups did not observe a significant difference in habit type and duration. Most OSCC patientswith OSMF were younger than those OSCC without OSMF. The buccal mucosa was the most common anatomical locationinvolved with ulcers- proliferative growth in both study groups. The incidence of multiple sites and lymph node enlargementinvolvement is higher in OSCC without OSMF compared to those with OSMF. There was no significant difference concerninghistopathological changes between OSCC with and without the OSMF group.

Oxidative Stress Enzyme as Markers in Oral Potentially Malignant Disorders and Oral Squamous Cell Carcinoma Patients.

Oxidative stress is a recognized factor that poses a significant risk for the development of Oral Squamous Cell Carcinoma (OSCC) and Oral Submucous Fibrosis (OSMF), as it leads to the generation of Reactive Oxygen Species. In recent years, there has been significant research on the enzymes MDA (malondialdehyde) and SOD (superoxide dismutase), investigating their potential role in the development of OPMD and OSCC. These enzymes have emerged as promising biomarkers due to their ability to provide a less invasive, cost-effective, and objective diagnostic method. Furthermore, they can be used to monitor disease progression and assess the effectiveness of therapy. The aim of this study was to assess the levels of MDA and SOD in the serum of patients diagnosed with OSCC and OSMF. Study group comprised of 60 patients, out of which 20 cases of clinically diagnosed OSCC patients and 20 cases of OSMF and 20 cases pf control comprising of healthy patients were recruited. Estimation MDA and SOD was done by ELISA. The statistical analysis was done using SPSS analysis. When comparing the levels of MDA and SOD between the OSCC and OSMF groups and the control group, statistically significant findings indicated elevated levels of malondialdehyde and reduced levels of superoxide dismutase in both the OSCC and OSMF groups. In this study, the assessment of lipid peroxidation through MDA levels revealed elevated concentrations in both the OSCC and OSMF groups when compared to the control group. Specifically, the order of MDA levels was observed as OSCC > OSMF > Control. Conversely, antioxidant enzyme levels, such as SOD, exhibited decreased concentrations in the OSCC and OSMF groups compared to the control group, with the order of SOD levels being Control > OSMF > OSCC. Consequently, the findings suggest that MDA and SOD can be considered potential biomarkers for identifying and monitoring OSCC and OSMF diseases.

Evaluation of extracellular matrix changes among oral submucous fibrosis and oral squamous cell carcinoma patients of Malwa region of Punjab using special histochemical stains: An insight into cancerous transformation.

To assess extracellular matrix changes among oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) patients using special histochemical stains. Twenty biopsy specimens of OSMF and 30 biopsy specimens of OSCC were included in the present study. Among 20 OSMF specimens, 10 were of early OSMF and the remaining 10 were of advanced OSMF. Out of 30 OSCC specimens, 10 cases each were of well-differentiated OSCC, moderately differentiated OSCC and poorly differentiated OSCC. Three sections, each 4 μm thick, were obtained from all specimens. One section was stained with routine H&E staining, whereas the other section was stained with Masson's trichrome (MT) stain for collagen and Verhoeff-Van Gieson (VVG) for elastic fibres. Evaluation of all specimens was performed under the light microscope. The arrangement of collagen fibres and elastic fibres was compared between the OSMF group and OSCC group, in between different grades of OSMF and in between different grades of OSCC. The results were evaluated using SPSS software. Early OSMF cases were associated with fibrosis in the superficial lamina propria, whereas advanced OSMF had fibrosis involving deeper muscle fibres. In all early OSMF cases, elastic fibres were arranged in thin bundles, whereas in advanced OSMF cases, elastic fibres were in thick bundles. In well- and moderately differentiated OSCCs, the collagen fibres were arranged in thick bundles and in poorly-differentiated OSCCs, the collagen fibres appeared to be fragmented. The elastic fibres in well-differentiated OSCC and moderately-differentiated OSCC were thickly arranged, and poorly-differentiated OSCC showed thin fibres and 70% of cases showed the absence of elastic fibres. Changes observed in both collagen and elastic fibres in the extracellular matrix (ECM) can be taken as a study model to further understand the progression of OSMF to OSCC using histochemical stains.

Relation of salivary MMP-8 with oral submucous fibrosis and oral squamous cell carcinoma: a cross sectional analytical study

ObjectivesWe aim to evaluate salivary matrix metalloproteinases (MMP-8) levels in oral submucous fibrosis (OSF) and oral squamous cell carcinoma (OSCC) for the purpose of diagnosis at the early stage via...

Estimation of Serum Iron in the Patients of Oral Submucous Fibrosis

Objective: To compare the serum levels of iron in Oral Submucous Fibrosis (OSMF) and normal healthy subjects. Subject and Methods: A total of 120 patients with symptoms and signs suggestive of OSMF equally divided into two groups named group A and B. Patients satisfying the insertion norms and those who has oral sub mucous fibrosis and the control group who are willing to get participate and getting done their blood tests for other purpose were asked for additional iron serum test for our research purpose. The demographic and medical factors like gender, pain, age, and medical record was known and logged in proforma. Diagnosis was done on clinical basis and was categorized according to progress then blood sample was obtained. The data was examined using SPSS version 20.0. Results: Control group's descriptive (standard/healthy) statistics indicate the mean iron levels of iron 94.13 ug/dl, while standard deviations are 17.57ug/dl. On the 1st day, 2nd day and 3rd day serum levels are examined, which reveal the mean values of 28.02, 22.81 and 24.0 ug/dl, respectively. The findings indicate a greater average of iron (17.57) in the healthy group (group B), while considerably less mean of iron level (6.47) in patients who have OSMF (group A). Conclusion: The study concluded that OSMF have lower levels of the iron in the serum while higher levels in the healthy group. Keywords: Serum Iron Level, Oral Submucous Fibrosis, Estimation

Assessing the Candida in Healthy Subjects and Subjects with Oral Submucous Fibrosis: A Comparative Clinical Study

One precancerous condition with a high potential to turn into malignancy and pose a high risk is OSMF (oral submucous fibrosis) which mainly affects the young subjects globally as well as in India. The etiology of OSMF is attributed to the gutkha chewing habit. Another predominant etiologic factor governing the etiopathogenesis of malignant and premalignant lesions is the Candida species. Our aim of the present clinical study was conducted to assess and compare the intensity and incidence of Candida species in healthy subjects and subjects with oral submucous fibrosis. This study included 24 healthy controls and 24 subjects with a confirmed diagnosis of OSMF. A detailed history was recorded and a clinical examination was done for all the study subjects. All the samples were obtained from the oral rinse and were cultured using Sabouraud’s agar medium followed by identification and counting of isolated yeast species on sugar assimilation test, chlamydospore formation, and germ tube test. In the OSMF group, Candida species were isolated from 41.66% (n=10) of subjects. However, in the control group, Candida species were isolated from 16.66% (n=4) of the collected samples. This identification difference showed that higher species were isolated from the OSMF group compared to the control group (p=0.07). In the OSMF group, CFU/ml had a range of 500-970 with mean CFU values of 721.27±143.88. In the control group, the CFU/ml range was 60-320, whereas, the mean CFU/ml value was 186.64±130.10. The mean value was higher in the OSMF group compared to the control group. This difference was statistically significant with a p-value of 0.005. The present study concludes that the intensity and incidence of C. Albicans, candida species was higher in subjects with OSMF compared to healthy controls, however, these species were in the normal range of 3% to 47%. Hence, Candida cannot be considered an etiologic factor for transforming OSMF into a malignant lesion. However, further evaluation is needed to evaluate if betel quid chewing in subjects with OSMF promotes or inhibits the invasion and adherence of Candida species.

Analysis of copper and zinc levels in the mucosal tissue and serum of oral submucous fibrosis patients

Background and Objectives:Although the pathogenesis of oral submucous fibrosis (OSMF) has been studied, it remains unclear whether or not this illness might progress to malignancy. The pathogenesis of the illness may be better understood by measuring copper and zinc levels in tissue and serum from these people. Because of the widespread cultural and social usage of areca nuts in India, a research was conducted to investigate their concentrations in this population. Methods:Twenty people with OSMF and twenty people without it were studied in a case-control fashion. Copper and zinc concentrations were measured in the 40 patients' tissues and blood using colorimetry. Compared to the zinc concentration of 25.18 4.92 g/gm found in OSMF group tissues, copper concentration was 4.31 1.13 g/gm. Zinc levels were 0.92 0.18 g/ml and serum copper levels were 1.00 0.20 g/ml on average in the OSMF group. Interpretation and conclusion:OSMF group tissue zinc levels were substantially different from control group levels (p = 0.009), as were OSMF group tissue copper levels (p = 0.001). There was no statistically significant difference in serum copper (p = 0.35) or zinc (p = 0.08) between the experimental and control groups.

Evaluation of Hematological Profile in Oral Submucous Fibrosis.

Background: The aim of the study is to assess the hematological profile in oral submucous fibrosis (OSMF) patients.Methods: The study's participants (100) were divided into two groups. Group I consisted of fifty areca nut chewers with complaints of burning sensations, blanching, and stiffness of the oral mucosa. Group II consisted of fifty healthy patients as controls. A hematological profile was estimated in all subjects.Results: The control group had a mean hemoglobin (Hb) of 13.87±1.26 g/dL, while the OSMF group had a mean Hb of 11.03±2.16 g/dL (P=0.001). The mean serum iron level in the control group was 120.36±41.22 g/dL, while it was 44.97±13.45 g/dL in the OSMF group (P=0.001). The control group's mean serum vitamin B12 values were 424.77±110.95 g/dL, while the OSMF group's was 210.11±44.88 g/dL (P=0.001). In the research population, 47 patients had iron deficiency. The odds ratio (OR) was 28.11, which meant that the high prevalence of iron deficiency was predicted 28.11 times more often than in the control group.Conclusion: As part of a biochemical assessment, iron status is assessed as part of a prevention mechanism for people who are at high risk. Biochemical testing has been suggested as a potential tool for mass screening OSMF patients.

Otological manifestations in oral submucous fibrosis: Our experiences

Background: Oral submucous fibrosis (OSMF) is a chronic premalignant condition seen in the oral cavity, but sometimes extends to the pharynx, esophagus, or even the larynx. OSMF causes stiffness in the oral cavity leads to trismus and affects speech and swallowing. Sometimes this lesion affects the Eustachian tube opening at the nasopharynx which results in Eustachian tube dysfunction followed by middle ear diseases. The purpose of the present work is to evaluate otological manifestations in OSMF patients. Materials and Methods: Patients with OSMF were evaluated for otological manifestations such as hearing impairment and fullness in the ear. All of them were evaluated with pure tone audiometry and tympanometry. Results: In this study group of 58 patients of OSMF comprising 116 ears, the hearing was within the normal limit in 60 ears (51.72%), a mild degree of conductive deafness in 52 ears (44.82%), a mild degree of sensorineural deafness in 2 ears (1.72%) and a moderate degree of sensorineural deafness were present in 2 ears (1.72%). There is a significant difference in mean quantitative hearing impairment was seen in OSMF groups C and group D with respect to the control group. Conclusion: Involvements of palatal muscles in OSMF patients reduce the patency of the Eustachian tube, resulting in a conductive type of deafness. OSMF patients should be assessed for hearing impairment and suggested for proper management.

Soft palate morphology in OSMF patients: Radiographic evaluation

Oral submucous fibrosis (OSMF) is a chronic progressive, scarring disorder of oral cavity, which includes buccal mucosa, tongue, lips, anterior faucial pillars, soft palate, and oropharynx. Changes in soft palate morphology will start even before the OSMF, present itself clinically. These changes can lead to sleep apnea, difficulty in speech, swallowing &amp; respiration. Various radiographs are good diagnostic aid to assess the soft palate and its morphology or any changes in morphology. To evaluate and compare soft palate morphology and dimensions in various stages of OSMF with control by radiographic evaluation.: 60 patients were evaluated and compared for soft palate morphology, its length, width and angle by using lateral cephalogram and Cone beam computed tomography (CBCT). Most common type of soft palate was found to be type 1 (leaf shaped) in both groups as well as by both radiographic techniques. Significant decrease in length and increase in width with increasing grades of OSMF group. As per p value CBCT gave more precise result. As the OSMF progresses soft palate becomes stout and bulky and significant changes occur in soft palate dimensions and are better evaluated by CBCT. As involvement of the soft palate is the earliest change to be noticed, radiographs should be used as one of the diagnostic aids in OSMF patients.

Alteration in Serum Lipid Profile Pattern in Oral Squamous Cell Carcinoma and Potentially Malignant Disorders

Objective: To evaluate and compare lipid profile level in oral submucous fibrosis (OSMF), oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) patients . Material and Methods: Thirty histopathologically diagnosed subjects each of OL, OSMF, OSCC were recruited along with 30 healthy controls. 5ml of venous blood is collected and estimated using standard diagnostic kits. Results: The mean of Total cholesterol level in controls was 219.03 mg%, in OSCC, OL and OSMF was 142.89 ± 10.21mg%, 155.44 ± 17.63 mg% and 180.60 ± 13.25 mg%, respectively. The mean low-density lipid level in controls was 137.24 mg and in OSCC, OL and OSMF groups were 109.28 ± 2.16 mg%, 126.63 ± 0.85 mg% and 119.15 ± 0.93 mg%, respectively. The mean of high-density lipid level in controls, OSCC, OL and OSMF was 42.87 ± 0.42 mg%, 36.50 ± 2.31 mg%, 21.13 ± 0.77 mg% and 28.37 ± 1.11mg%, respectively. The mean of very low density lipids level in controls, OSCC, OL and OSMF was 30.12 ± 1.51 mg%, 17.24 ± 0.80 mg%, 22.25 ± 0.93 mg% and 25.89 ± 0.43 mg%, respectively. The mean triglyceride level in controls, OSCC, OL and OSMF was 118.80 ± 9.47 mg%, 91.2 ± 3.03 mg%, 105.05 ± 2.96 mg% and 106.19 ± 3.09 mg%, respectively . Conclusion: Lipid profile levels could be early indicators of precancer and cancer.

Clinicopathological Correlation of Cyclooxygenase 2 Expression in Oral Submucous Fibrosis: An Immunohistochemical Study.

ABSTRACTBackground:Oral submucous fibrosis (OSMF) has a high prevalence in Southeast Asia with increased malignant transformation rates. Numerous biomarkers are currently being investigated to predict the disease prognosis and for early detection of malignant changes.Materials and Methods:A prospective study was conducted comprising 40 subjects with clinically and biopsy-proven OSMF being included in the study as experimental group (n = 28) and patients with no tobacco/betel nut habit, who underwent surgical removal of third molar, being included as control group (n = 12). About 5-μm sections from formalin-fixed paraffin-embedded tissue blocks were obtained for immunohistochemical (IHC) study. The expression of cyclooxygenase 2 (COX 2) was evaluated in the experimental group and compared in morphologically normal oral epithelium. The intensity of stain was assessed at different levels of epithelium (basal, stratum spinosum, superficial level) and connective tissue.Results:Based on IHC expression of COX 2, all the patients of the control group were negative for COX 2, and among the OSMF group, 19 patients (67.9%) were positive and 9 patients (32.1%) were found to be negative for COX 2. The association of COX2 expression on comparison of controls with OSMF was found to be statistically significant (χ2 =21.955; P = 0.000). On comparison of immune expression of COX 2 in different clinical stages based on functional staging, we found significant association of COX 2 expression with the stage of OSMF (χ2 = 7.368; P = 0.025).Conclusion:The significant expression of COX 2 in different clinical stages of OSMF when compared with normal shows the role of COX 2 in the pathogenesis of OSMF and could serve as a potent biomarker for assessing the disease progression.

Relationship of Clinical Features with Candidal Carriage in Oral Submucous Fibrosis Patients: A Case-control Study.

Background and Objectives:Oral submucous fibrosis (OSF) is extensively prevalent in India and South-East Asia owing to the habit of arecanut (AN) use. Epithelial atrophy, hyposalivation, and immune alterations in OSF may predispose to increased Candidal carriage. Stomatopyrosis in OSF can result from multiple causes, which may also include Candidal infection. Hence, this study is aimed to assess Candidal carriage, species characterization, salivary flow rate (SFR) and its relationship with the clinical features (stomatopyrosis and mouth opening [MO]) in OSF patients alongwith the response to antifungal treatment in patients with higher Candidal carriage.Methodology:In this case-control study, 60 OSF patients and 30 age- and sex-matched control subjects were enrolled. SFR was assessed using modified Schirmer test. Samples for Candidal assessment were collected with the oral rinse technique and cultured. The isolated yeast species were counted and identified based on Gram staining, germ tube test, and CHROMagar. Data were analyzed with Chi-square test, Pearson's correlation test, and one-way ANOVA test.Results:The distribution of mean visual analog scale (VAS) score, SFR and MO was significantly varied (P < 0.001) in the study and control groups. Candida was found to be present significantly (P = 0.048) in OSF group as compared to control group. Candida albicans was the predominant species. No statistically significant association was obtained regarding Candidal isolation and SFR, burning sensation and MO in OSF patients. Only 1 patient in the study group yielded a high Candidal carriage (>400 CFU/mL) and reported relief in burning sensation (VAS score) with antifungal therapy.Conclusions:OSF patients yielded a significant higher oral Candidal carriage. Although it was not found to be associated directly, its role as a “cause and effect” in SFR and clinical features (stomatopyrosis and MO) of OSF cannot be ignored.

To correlate the immunohistochemical analysis of p16 and Ki-67 in oral squamous cell carcinoma with the background of oral submucous fibrosis

Aim: Oral submucous fibrosis (OSF) is a potentially malignant disorder with 7.6% of malignant transformation rate into oral squamous cell carcinoma (OSCC). The aim of the study is to assess the genetic markers p16 and ki-67 in OSF, OSCC, and OSCC with the background of OSF and control group. Materials and Methods: Ten cases of each group were stained with p16 and Ki-67 by immunohistochemistry technique. Results: Statistically significant results were found among the four groups with moderate-to-severe expression (P < 0.05) for Ki-67 and results were negative for p16 in all groups. Conclusion: According to our result, p16 is found not significant marker and Ki-67 can be useful as a proliferative index marker for malignancy development in oral precancerous conditions.