Oral Submucous Fibrosis Group Research Articles

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 & 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.

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.

Audiometry Analysis for the Assessment of Hearing Deficit in Patients with Oral Submucous Fibrosis

Introduction: Oral Submucous Fibrosis (OSMF) is a slowly progressive chronic fibrotic disease of the oral cavity extending to pharynx. Function and patency of eustachian tube gets altered when the palatal and paratubal muscles which regulate the patency of pharyngeal orifice gets affected. This leads to pain in ear along with mild to moderate conductive loss of hearing. Aim: To evaluate hearing deficit in OSMF patients and to correlate clinical stages of OSMF with degree of hearing deficits in patients. Materials and Methods: It was a cross-sectional study. The study comprised of a total of 50 subjects (100 ears). Forty patients diagnosed with OSMF who reported to Department of Oral Medicine and Radiology constituted the study group. Ten normal individuals with no deleterious habits and without any previously diagnosed ear disorders constituted the control group. Pure Tone Audiometry (PTA) was used for evaluating all the subjects for air conduction and bone conduction hearing loss. Values on qualitative characteristics were shown as n (% prevalence) across five study groups. Values on quantitative variables were shown as Mean±SD across five study groups. Inter group comparison for qualitative and quantitative variables was done using chi-square test and analysis of variance (ANOVA) test respectively with Post-Hoc Bonferroni’s correction for multiple group comparisons. Results: The OSMF group showed a marked degree of hearing loss compared to the control group. The distribution of mean PTA in quantitative assessment was significantly higher in group D compared to group A and group B (p-value&lt;0.05 for both) and also the distribution of qualitative hearing loss was significantly higher in group C and group D (p-value&lt;0.05). Conclusion: There was a significant association between OSMF and hearing deficit in this study. Fibrosis of the oropharynx and palatal/paratubal muscles which are affected in OSMF and theses muscles are attached to eustachian tube, the patency of the eustachian tube gets affected. As a result, patients with mainly advanced cases of OSMF should be assessed for hearing deficit.

The prevalence of oral squamous cell carcinoma with oral submucous fibrosis.

The objective of the study was to find out the prevalence of oral squamous cell carcinoma (OSCC) with oral submucous fibrosis (OSF) in patients with OSF. Of 48,757 patients, we found 300 OSF subjects. Three hundred patients of OSF were checked for OSCC. Both OSF and OSCC with OSF (OSCCwOSF) were diagnosed histopathologically. The prevalence of OSCCwOSF was calculated. Descriptive analysis was done. Chi-square test and t-test were calculated for proportions and mean, respectively, to check any difference among OSF and OSCCwOSF groups. Age-specific relative risk was calculated in OSF and OSCCwOSF groups. Multiple logistic regression analysis was done among odd ratios of the different variable between OSF and OSCCwOSF groups. The prevalence of OSCCwOSF among OSF was 13.7% over a period of 1 year. The mean age of OSCCwOSF group was 43.95 ± 10.22 years in comparison to the OSF group that was 35.51 ± 11.26 years (P < 0.00). The mean habit duration was significantly less in the OSF group when compared to OSCCwOSFgroup for mishri (P = 0.002). Age-specific adjusted relative risk of OSCC in OSF patient increases from 0.33 (18-34 years) to 3.86 (≥65 years). It could be concluded that a 13.7% prevalence rate of OSCCwOSF in OSF patients should alert the clinician. Clinicians should, therefore, anticipate OSSC in OSF patients. This awareness could lead to the early diagnosis and management of such OSCC.

Carcinogenesis of Male Oral Submucous Fibrosis Alters Salivary Microbiomes

Most oral squamous cell carcinoma (OSCC) tumors arise from oral premalignant lesions. Oral submucous fibrosis (OSF), usually occurring in male chewers of betel quid, is a premalignant stromal disease characterized by a high malignant transformation rate and high prevalence. Although a relationship between the inhabited microbiome and carcinogenesis has been proposed, no detailed information regarding the oral microbiome of patients with OSF exists; the changes of the salivary microbiome during cancer formation remain unclear. This study compared the salivary microbiomes of male patients with OSCC and a predisposing OSF background (OSCC-OSF group) and those with OSF only (OSF group). The results of high-throughput sequencing of the bacterial 16S rRNA gene indicated that OSF-related carcinogenesis and smoking status significantly contributed to phylogenetic composition variations in the salivary microbiome, leading to considerable reductions in species richness and phylogenetic diversity. The microbiome profile of OSF-related malignancy was associated with increased microbial stochastic fluctuation, which dominated the salivary microbiome assembly and caused species co-occurrence network collapse. Artificial intelligence selection algorithms consistently identified 5 key species in the OSCC-OSF group: Porphyromonas catoniae, Prevotella multisaccharivorax, Prevotella sp. HMT-300, Mitsuokella sp. HMT-131, and Treponema sp. HMT-927. Robust accuracy in predicting oral carcinogenesis was obtained with our exploratory and validation data sets. In functional analysis, the microbiome of the OSCC-OSF group had greater potential for S-adenosyl-l-methionine and norspermidine synthesis but lower potential for l-ornithine and pyrimidine deoxyribonucleotide synthesis and formaldehyde metabolism. These findings indicated that the salivary microbiome plays important roles in modulating microbial metabolites during oral carcinogenesis. In conclusion, our results provided new insights into salivary microbiome alterations during the malignant transformation of OSF.

Genetic Implications of HLA-DR and HLA-DQ Genotype on Tobacco Smoking and Oral Submucous Fibrosis.

Integration of genetic information into our understanding of oral diseases has fostered the hope to intervene the disease process among genetically susceptible individuals. Oral submucous fibrosis (OSF) (mainly in the Southeast Asia region) and tobacco smoking are two of the major public health problems the world is facing today. With more and more diseases being associated with alleles of the human leukocyte antigen (HLA), the objective of the study was to explore any genetic association of OSF and smoking behaviour with specific HLA Class II DQB1*0503 and HLA DRB1*0301 alleles. Genomic DNA was extracted from saliva of 64 patients divided into an OSF group, a tobacco smokers group and a control group. This was followed by polymerase chain reaction (PCR) with sequence-specific primer of HLA-DQB1*0503 and HLA DRB1*0301 allele, visualised under 2% agarose gel. A statistically significant difference was observed between the OSF group and controls in presence of HLA-DQB1*0503 allele, with 84% of the patients showing the presence. Frequency of HLA DRB1*0301 allele was also found to be significantly higher (72%) among OSF patients (p <0.001). Similar results were shown in tobacco smokers with 28% cases showing presence of HLA DRB1*0301 allele and 13 (52%) of them having DQB1*0503 allele (p <0.001). HLA-DRB1*0301 and HLA-DQB1*0503 are statistically significantly associated with susceptibility to OSF and smoking behaviour.

Effect of Turmeric on Serum Malondialdehyde levels in Oral Submucous Fibrosis

Background: Aspergillus flavous in betel nut secretes aflatoxin i.e. mycotoxin &amp; tobacco which leads to production of free radicals and reactive oxygen species, thus increasing lipid peroxidation. Biological parameter of Lipid peroxidation is malondialdehyde. Hence present study was conducted to evaluate effect of turmeric on increased lipid peroxidation by using serum malondialdehyde levels &amp; as a surrogate outcome on clinical signs &amp; symptoms of oral submucous fibrosis (OSMF). Methods: In this study 270 subjects of which 30 were suffering from OSMF on turmeric with counseling them about stoppage of habit (group A), 30 subjects suffering from OSMF on turmeric without counseling them about stoppage of habit (group B), 30 subjects suffering from OSMF counseled for stoppage of habit but without turmeric medication (group C), 90 cases which were betel-nut habitual without OSMF (group D), 90 cases healthy control group (group E). Results: Statistically significant reduction in Serum MDA levels post treatment group A patients as compared to group B &amp; group C (p&lt;0.05). Mean difference was observed as 9.00 in group A, 3.81 in group B, 2.62 in group C. Conclusion: Increased serum MDA in OSMF can be used as an important marker in early diagnosis, treatment, prognosis and for prevention and clinical intervention of the disease. The antioxidant properties of turmeric reduce the oxidative stress even with effects of areca alkaloids. Serum MDA level was decreased in subjects taking turmeric medication for the period of 4 weeks

Expression of Salivary S100A7 Levels in Stage I Oral Submucous Fibrosis: A Clinical and Laboratory Study.

Background:Oral submucous fibrosis (OSF) is a chronic debilitating condition characterized by juxta-epithelial fibrosis. The main etiological agent associated with the high-risk precancerous condition is areca nut use. S100A7 is a member of the largest calcium-binding proteins exclusively found in vertebrates and are associated with the regulation of numerous intracellular and extracellular functions. The aim of this study was to investigate the expression of protein S100A7 in salivary samples of individuals with stage I OSF and healthy controls. Methods:This study included 63 participants, 30 of whom had OSF stage I and 33 healthy controls. Nonprobability quota sampling technique was utilized for recruitment of the study participants. A structured baseline questionnaire was used to collect demographic data. Saliva samples were collected by passive droll technique in a sterile container. Salivary levels of S100A7 were quantified by enzyme-linked immunosorbent assay. For the normality of the data Shapiro Wilk test was performed. Student t-test was commuted to evaluate the expression of S100A7 protein expression between both the study groups. Results:The mean salivary S100A7 value for stage I OSF group was 0.334 ng/ml, compared to 0.172 ng/ml for healthy controls. Student t-test reported a statistically significant difference, indicating higher levels of S100A7 in stage I OSF group than in healthy controls (p < 0.001). In the individual group analysis, a significant negative correlation was found between salivary S100A7 and duration of areca nut use (r = –0.45, p = 0.009) and gutka chewing (r = –0.20, p = 0.03), while a significant positive correlation was found between salivary S100A7 and mouth opening (r = 0.03, p = 0.04). Conclusions:Higher levels of S100A7 protein level was seen in stage I OSF group in comparison to the healthy individuals. Results of our study suggest that S100A7 could be used as a surrogate assessment to identify patients at risk of OSF development.

Evaluation of serum lipid profile and complete hemogram in patients with oral submucous fibrosis: A case control study

Aim: Not many studies in the literature are found that include all the variables under complete blood picture along with lipid profile. The aim of study was to evaluate the serum lipid profile and complete blood picture in patients with oral submucous fibrosis (OSMF). Materials and Methods: It is a case control study with the sample size of 40 patients considered by random sampling, which includes 20 clinically diagnosed patients with OSMF as per the diagnostic criteria of Passi et al. and 20 sex-matched controls. Five milliliters of blood was collected from the most prominent vein of right cubital fossa and stored in test tubes. Centrifugation was carried out for about 4–5min at 2500rpm and the serum collected was stored at 4°C and subjected to auto analyzer for analyzing complete lipid profile and complete blood picture. Mann–Whitney U test was used to compare mean age, mean values of lipid profile parameters, and hematological parameters between OSMF and healthy group. Results: The serum lipid levels were significantly lower in patients with OSMF than in controls, and also patients with OSMF showed significantly lower levels of hemoglobin (Hb), red blood cells (RBCs), and platelets and increased levels of erythrocyte sedimentation rate (ESR) and white blood cell (WBC) than in controls. Conclusion: This study concluded that the lower serum lipid levels may serve as a diagnostic and prognostic indicator in the early diagnosis of oral premalignant lesions, and the findings in our study emphasize on the assessment of Hb, RBCs, WBCs, platelets, and ESR for patients with OSMF. So it is recommended to subject the patients with oral precancerous conditions to biochemical investigations as it may aid in early diagnosis and prognosis.

Evaluation of Hematological profile in Oral Submucous Fibrosis: A Cross-sectional Study.

Aims:The purpose of this study was to estimate hemoglobin (Hb) level, red cell indices (RCIs), serum iron level and Vitamin B12 level in patients with oral submucous fibrosis (OSMF) and to analyze the association of these parameters in different stages of OSMF.Setting and Design:This case–control study comprised of 65 individuals, with 40 OSMF patients and 25 controls. The OSMF patients were graded clinically according to the classification by Arakeri et al. Fasting blood samples were collected from both groups for hematological evaluation.Statistical Analysis Used:The mean values and standard deviations were calculated by Chi-square test. Normality of various parameters was evaluated by Kolmogorov–Smirnov test. The independent t-test was used to compare more than two means simultaneously. Correlation analysis was done by Karl Pearson's correlation coefficient method.Results:The OSMF patients were in the age range of 21–67 years, with a mean age of 39.85 ± 10.42 years. The mean value of Hb of the control group was 14.24 ± 1.03 g/dL, whereas that of OSMF group was 11.18 ± 2.06 g/dL (P < 0.001). The mean value of the serum iron level of the control group was 119.67 ± 42.42 μg/dL, whereas that of the OSMF group was 45.04 ± 10.41 μg/dL (P < 0.001). The mean value of serum Vitamin B12 levels of the control group was 422.98 ± 112.57 μg/dL, whereas that of the OSMF group was 211.78 ± 45.17 μg/dL (P < 0.001). The RCIs including packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH) and MCH concentration were significantly reduced in OSMF cases. Iron deficiency was present in 38 patients among the study group and Vitamin B12 deficiency was present in 22 patients of the study group.Conclusion:OSMF causes depletion of minerals and trace elements, and its replenishment is required for the healing of tissues and performing daily routine activities.

Morphometric Evaluation of Soft Palate in OSMF Patients Using Cephalometrics.

Oral submucous fibrosis (OSF) is a chronic disease and a well-recognized potentially malignant condition of the oral cavity characterized by inflammation and a progressive fibrosis of the lamina propria and deeper connective tissues. To study the morphology of soft palate in different stages of OSF on digital lateral cephalogram. To compare the changes in morphology of soft palate in OSF patients with control. The study was conducted from 2017 to 2018 on 217 patients with their age ranging from 17 to 60years. All patients detailed clinical examination and history was taken and cephalometric evaluation was done. Type I (51.14%) was found to be the most common in OSF group followed by type II (21.86%) and type VI (13.64%). The present study highlighted the variable radiographic appearances of the soft palate on lateral cephalograms with type I as most common morphology. Cephalometric analysis is one of the most commonly accepted techniques for evaluating the soft palate in both normal individuals and in those with cleft lip and palate.

Morphometric assessment of soft palate in oral submucous fibrosis using cone beam computed tomography: A cross-sectional study

Context: Oral submucous fibrosis (OSMF), a chronic disorder, presents with limited mouth opening and fibrosis of the lining mucosa of the upper digestive tract involving the oral cavity, oropharynx, and commonly the upper third of the esophagus. Studies assessing morphological changes of soft palate using cone beam computed tomography (CBCT) may construe functional alterations. Aims: The objective of our study was to assess (1) the morphological variations of soft palate, (2) its comparison with different OSMF grades and control groups by CBCT, and (3) velopharyngeal incompetency. Setting and Design: The study attributed the clinical features of OSMF based on Pindborg's classification. Patients were scanned for morphometric assessment of soft palate. Materials and Method: CBCT images of 45 OSMF patients and 45 control-group patients were analyzed using Statistical Package for the Social Sciences version 20 (SPSS Pvt Ltd. Chicago, IL, USA). Two investigators performed the morphometric analysis, and the average was taken.Statistical Analysis: Independent t-test was applied. Results: A total of 90 patients were imaged. Leaf-type morphology was the most common, and Stage III had the maximum of butt-type morphology. Mean velar width was significantly higher in the OSMF group compared to the control group. Conclusions: The study illustrated three-dimensional soft palate images including the morphology in different OSMF grades, thereby accurately measuring various parameters of soft palate. As OSMF progresses, the morphology of soft palate changes eventually from Type I to other types. Morphological changes can be reversed or arrested from further worsening if assessed in the first phase of OSMF.

Role of immunological alterations in oral submucous fibrosis

Background: Oral Submucous fibrosis (OSMF) is a premalignant condition affecting the oral mucosa. It is observed to have a multifactorial etiology including genetic predisposition and autoimmune origin. This study aimed to study the etiological role of immunological factors in OSMF. Settings and Design: It was a prospective study carried out in the Department of Oral Medicine and Radiology at Lenora Institute of Dental Sciences, Rajahmundry. Aims and Objective: To estimate and compare the serum IgG and IgA between the OSMF subjects and controls. To assess the statistical significance of the difference in the levels of albumin, globulin, total protein, IgG and IgA between study group and control group if any. Materials and Methods: It was an observational study in which the serum albumin, serum globulin, total protein, IgG and IgA were evaluated in a total of 60 patients who gave consent to participate in the study. Results and Discussion: Increase of IgG was observed in 9 (30%) subjects of the OSMF group and in 4 (13.2%) of the control group. IgA level was increased in 2 (6.6%) subjects of OSMF group and in 5 (16.6%) subjects of the control group. However, this difference was not statistically significant. Conclusion: The findings from the study indicated an alteration in the immunoglobulin level in patients with OSMF. However, the association was not significant. Therefore, further and larger studies are advocated to verify the immunological association with OSMF. One important observation made in the study was a positive association between the duration of exposure and stage of OSMF. This implies that interventions which modify the arecanut chewing habits can bring about a reduction in OSMF and in turn oral cancer.

Delineating metabolic dysfunction in cellular metabolism of oral submucous fibrosis using 1H nuclear magnetic resonance spectroscopy

ObjectiveTo delineate the metabolism involved in oral submucous fibrosis progression towards carcinogenesis by 1H nuclear magnetic resonance spectroscopy. MethodsThe proposed study was designed using 1H-NMR by comparing the metabolites in the serum sample of oral submucous fibrosis (n = 20) compared to the normal group (n = 20) using 1H nuclear magnetic resonance spectroscopy. Various statistical analysis like multivariate statistical analysis, Principle component analysis, Partial least squares Discriminant Analysis, Hierarchical cluster analysis was applied to analyze potential serum metabolites. ResultsThe results generated from the principle component analysis, partial least squares discriminant analysis and hierarchical cluster analysis are sufficient to distinguish between oral submucous fibrosis group and normal group. A total of 15 significant metabolites associated with main pathways were identified, which correlated with the progression of cancer. Up-regulation of glucose metabolism-related metabolites indicated the high energy demand due to enhanced cell division rate in the oral submucous fibrosis group. A significant increase in lipid metabolism-related metabolites revealed the reprogramming of the fatty acids metabolic pathway to fulfilling the need for cell membrane formation in cancer cells. On the other hand, metabolites related to choline phosphocholine, the metabolic pathway was also altered. ConclusionOur findings could identify the differentiating metabolites in the oral submucous fibrosis group. Significant alteration in metabolites in the oral submucous fibrosis group exhibited deregulation in metabolic events. The findings reported in the study can be beneficial to further explain the molecular aspects that lead to the progression of oral submucous fibrosis towards carcinogenesis.

Differential expression of salivary S100A7 in oral submucous fibrosis

AimTo investigate the expression of salivary S100A7 levels among patients with oral submucous fibrosis (OSF) and healthy controls. MethodA total number of 60 participants were included in the study (30 OSF cases and 30 healthy controls). Demographic data was collected using a structured baseline questionnaire. Salivary S100A7 levels were quantified using enzyme-linked immunosorbent assay. Data was analyzed using Student t-test. Pearson correlation test was used to evaluate correlation between S100A7 levels and independent variables such as frequency and duration of areca nut use, gutka use, and mouth opening. ResultsThe mean value of salivary S100A7 for OSF group was 0.275 ng/ml, whereas mean value of salivary S100A7 for healthy controls was 0.195 ng/ml. Student t-test indicated that there was statistically significantly higher levels of S100A7 in OSF group as compared to healthy controls (p < .001). When the clinical variables of individual groups were analysed, a significant negative correlation was found between salivary S100A7 and duration of areca nut (p = .009) and gutka chewing (p = .03), whereas a significant positive correlation was found for mouth opening (p = .04). ConclusionOSF presented higher levels of salivary S100A7 levels as compared with healthy individuals and may be used as surrogate measure to identify subjects at risk for OSF.

Evaluation of aberrant metabolism related proteins in oral submucous fibrosis: A pilot study

ObjectivesThe mortality rate within five years of diagnosis is very high (>60%) for patients with oral cancer (OC), primarily due to late stage detection. Oral submucous fibrosis (OSF) is a heterogeneous oral lesion that has a high probability of developing into OC. One of the hallmark characteristics of malignant cells is alteration of metabolic pathways as the disease progresses towards carcinogenesis. This study aims to examine the altered metabolism-related proteins using immunohistochemistry (IHC). MethodsThe expression levels of glucose transporter 1 (GLUT1), hexokinase 2 (HK2), and fatty acid synthase (FASN) were analyzed in normal oral mucosa (NOM) (n = 30) and oral sub mucous fibrosis (OSF) (n = 30) using IHC. The degree of intensity and distribution of immunostaining was semi-quantitatively assessed. ResultsThe expression levels of GLUT-1, HK 2, and FASN were higher in the OSF group (p < 0.001) than in NOM control group. ConclusionsThese results indicate evidence of increased levels and alteration in the expression of metabolism-related proteins. Overexpression of these proteins may play an oncogenic role in the proliferative processes and disease progression of OSF. These results serve as a fundamental base for employing these proteins in future clinical applications.

Dysplastic features relevant to malignant transformation in atrophic epithelium of oral submucous fibrosis: A preliminary study.

The grading of oral epithelial dysplasia (OED) is not applicable to oral submucous fibrosis (OSMF) cases due to the presence of atrophic epithelium. The mucosal margins associated with resected OSCC specimens are often closely related to transformed cells. In this study, we compared the histomorphological alterations (dysplastic features) in the atrophic epithelium of OSMF patients with the mucosal margins of OSCC associated with OSMF (OSCC-OSMF). We evaluated 17 dysplastic features in 37 patients with OSMF (biopsy site: buccal mucosa) and 37 patients with OSCC-OSMF (mucosal margins involving buccal mucosa) using histopathological staining. Dysplastic features, such as keratin pearls within rete ridges, nuclear pleomorphism, and atypical mitotic figures, were not observed in the epithelium of the OSMF or OSCC-OSMF groups. Basal cell hyperplasia (P=.016), abnormal superficial mitosis (P=.010), increased nuclear-cytoplasmic ratio (P=.034), and hyperchromasia (P=.031) were predominantly seen in the OSCC-OSMF group. We found no statistically significant differences in the following parameters: irregular epithelial stratification (P=1.00), loss of basal cell polarity (P=.237), presence of drop-shaped rete ridges (P=.077), increased number of mitotic figures (P=.154), premature keratinization in single cells (P=.499), anisonucleosis (P=.289), anisocytosis (P=.079), cellular pleomorphism (P=.317), and increased number and size of nucleoli (P=.129). Increased basal cell layer hyperplasia, abnormal superficial mitosis, increased nuclear-cytoplasmic ratio, and hyperchromasia are high-risk features for OSMF, and affected patients should be followed on a priority basis for the early detection of OSCC.

Association of Candida species with Oral Submucous Fibrosis and Oral Leukoplakia: A Case Control study

Introduction: Oral Submucous fibrosis (OSMF) and Oral Leukoplakia (OL) are the most common Potentially Malignant Disorders (OPMD’s) seen in South Asia and South East Asian countries. A significant percentage of oral squamous carcinomas develop from pre-existing OPMD’s- Candida organisms is thought to be associated with these lesions. Aim: To determine the incidence and association of candida species in OSMF and OL. Methods: A Case control study was undertaken in 150 participants, which were equally divided into three groups. The smear or swab taken were subjected for Gram staining and Sabouraud’s dextrose agar. The Positive cultured Candida samples were analyzed by using HiMedia M 1297 HiCrome Candida Agar plates for determining the different species of Candida. Chi-square, one-way ANOVA and Tukey HSD Post Hoc test were used as statistical test. Results: The Gram staining was positive in oral swabs of 14 (28%) participants in OSMF group and 20 (40%) participants in OL group. Similarly, the oral swabs in 28% and 40% of the participants from OSMF and OL group were positive, when cultured in Sabouraud’s Dextrose Agar medium. The positive specimens on culturing in HiMedia M 1297 HiCrome Candida Agar plates detected Candida albicans and non albicans significantly (p<0.001) n OSMF and OL group. Conclusions: The Candida albicans and non albicans are associated with OSMF and OL. The findings of our study may act as diagnostic and prognostic marker, although role of candida in carcinogenesis is still a hypothesis and requires more research.