Submucous Fibrosis Research Articles

Evaluating the efficacy of curcumin in the management of oral potentially malignant disorders: a systematic review and meta-analysis

Background Oral potentially malignant disorders (OPMDs) not only harbour the risk of malignant transformation but can also affect patients’ quality of life owing to severe symptoms. Therefore, there is an urgent need for therapeutic strategies to improve patients’ quality of life. The objective of this meta-analysis was to comprehensively assess the efficacy of curcumin in the management of OPMDs. Methods PubMed, Embase, the Cochrane Library, and Web of Science were searched for clinical trials evaluating the efficacy of curcumin in the treatment of OPMDs from inception until March 2024. RevMan 5.4 software was used to perform statistical and subgroup analyses. Results Sixteen randomised controlled trials (1,089 patients) were selected. Curcumin exhibited comparable efficacy to conventional controls in alleviating pain (I2 = 98%, P = 0.49) and improving tongue protrusion (I2 = 94%, P = 0.51) in oral submucous fibrosis (OSF). Additionally, topical use of curcumin had an efficacy equivalent to that of conventional therapy in reducing pain (I2 = 83%, P = 0.31) and facilitating clinical remission (I2 = 67%, P = 0.38) of oral lichen planus (OLP). Conclusion The topical use of curcumin may palliate pain and promote clinical healing in OLP patients. Systemic curcumin can ameliorate the degree of pain and tongue protrusion in OSF. Therefore, our study suggests that curcumin could serve as an alternative treatment for managing OPMDs with lower medical toxicity than steroids, especially when steroids are not suitable. Further studies with larger sample sizes and adequate follow-up periods are required to validate our results.

Quantitative proteogenomic characterization in MUC1 and MUC4 in oral squamous cell carcinoma, oral potentially malignant disorders, and normal oral mucosa in carcinogenesis.

Mucins are glycoproteins with a significant molecular weight that have a diverse range of biological functions. MUC1 & MUC4 are transmembrane mucin family members that are expressed in airway epithelial cells and body fluids. It is expressed excessively in numerous carcinomas in addition to their alteredexpression. A thorough review of the literature reveals very limited research about MUC1 & 4 expressionsin oral malignancies and oralpremalignant disorders. The aim of the research is to assess the pattern and quantity of gene expression in MUC1 & MUC4 individually in various grades of oral squamous cell carcinoma (OSCC), oral premalignant disorders (OPMDs)- oral epithelial dysplasia (OED), oral submucous fibrosis (OSF), oral lichen planus (OLP), and compared with normal oral mucosa (NOM). Immunohistochemistry and qRTPCR evaluation of MUC1 & 4 on sixty-three cases of OSCC, OPMD, and NOM was accomplished. The one-way ANOVA test and Chi-square test were done for statistical analysis. The overall immunoexpression of MUC1 & 4 increased significantly from NOM to OPMDs to OSCC. In the subgrades of OSCC and OPMDs, the staining intensity varied. For MUC4, the intensity was strongest in well-differentiated grades and MUC1, exhibiting a higher expression in poorly differentiated grades of OSCC and OPMDs. The study's results indicate that MUC1 & 4 individually are crucial formonitoringOSCC and OPMD pathogenesis as the former gives an idea of highly undifferentiated grades while the latter indicated more differentiated tumors and perhaps a better prognosis. Therefore, the two can be useful tumor markers for determining the severity and eliminating it in its early phases.

Efficacy of Intralesional Injection of PRP over Other Treatment Modalities in the Management of Oral Submucous Fibrosis: A Systematic Review

Efficacy of Intralesional Injection of PRP over Other Treatment Modalities in the Management of Oral Submucous Fibrosis: A Systematic Review

Diagnostic potential of salivary IL-1β, IL-8, SAT, S100P, and OAZ1 in oral squamous cell carcinoma, oral submucous fibrosis, and oral lichen planus based on findings from a Sri Lankan cohort

The research examined the salivary concentrations of various biomarkers, such as OAZ1, SAT, S100P, IL-1β, and IL-8 aiming to detect early-stage oral squamous cell carcinoma (OSCC). These biomarkers show potential as indicators for detecting both pre-cancerous and cancerous states within the oral cavity. Analyzing these specific molecules in saliva could help clinicians enhance diagnostic accuracy and refine early detection methods for OSCC. The research encompassed a cohort of nine OSCC patients, ten with oral submucous fibrosis (OSF), eleven individuals with oral lichen planus (OLP), and ten healthy controls. The study focused on assessing the expression levels of key biomarkers—IL-1β, IL-8, SAT, S100P, and OAZ1 mRNA—in extracellular RNA extracted from saliva samples. This evaluation was conducted using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) with sequence-specific primers. Additionally, receiver operating characteristic curve (ROC) curve analysis was employed to gauge the efficacy of these biomarkers in detecting OSCC. Based on the results we observe, when these five biomarkers are used together, they give a 90% predictive probability for patients with OLP, an 80% predictive probability for OSF, and an impressive 100% predictive probability for patients with OSCC (AUC = 1.000, p = 0.000). This study demonstrates the efficacy of salivary transcriptome diagnostics in detecting OSCC. This novel clinical technique has the potential to be a powerful, efficient, and reliable tool for early detection of cancer. Salivary transcriptomes can be further analyzed to evaluate their effectiveness in other important illness contexts and for regular health monitoring.

Prevalence of oral submucous fibrosis across diverse populations: a systematic review and meta-analysis.

The aim is to offer a comprehensive overview of oral submucous fibrosis (OSF) prevalence and explore its epidemiological characteristics across various demographic groups and geographical locations, thereby helping the formulation of public health management policies. Studies reporting OSF prevalence were identified from electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, EMBASE via OVID, and Web of Science. Pooled prevalence and quality assessment using the New-Ottawa Scale were conducted. Two reviewers screened and selected records, assessed quality, and independently extracted data. This systematic review and meta-analysis followed the PRISMA guidelines and was registered on PROSPERO (CRD42024532975). Sixty-three studies, encompassing 11,434 cases in a total population of 769,860, reported OSF prevalence. The majority of studies (forty-one) were from India. The pooled prevalence of OSF across all populations was 3.0% (95% CI [2.8-3.2]%). In non-risk populations, risk populations, and consecutive dental patients, the pooled prevalence stood at 2.4% (95% CI [2.1-2.6]%), 4.5% (95% CI 3.5-5.6%), and 5.6% (95% CI [3.8-7.5]%), respectively. Subgroup analysis by age, sex, and geographical region revealed higher prevalence rates among those aged 50 and above (4.2%, 95% CI [3.0-5.4]%), males (3.3%, 95% CI [2.9-3.7]%), and in India (4.0%, 95% CI [3.7-4.3]%). As the exposure to risk factors exceeded 50% in the surveyed population, the prevalence of OSF notably increased. Most studies met satisfactory quality standards. Our research findings reveal a comprehensive prevalence of OSF across all populations at 3.0% (95% CI [2.8-3.2]%). And, existing evidence indicates a relatively low prevalence of OSF associated with tobacco, alcohol, and Areca (betel) nut use. However, further large-scale studies are recommended to validate these findings. Understanding the prevalence and distribution patterns of OSF may assist in healthcare intervention planning and alleviate the oral cancer burden associated with OSF.

HIF-1Α IN SALIVA: A PROMISING BIOMARKER FOR EARLY DIAGNOSIS OF ORAL SUBMUCOUS FIBROSIS AND ITS MALIGNANT POTENTIAL

Oral submucous fibrosis (OSF) is a chronic condition with a high risk of transforming into oral squamous cell carcinoma (OSCC). Identifying reliable biomarkers for early diagnosis and monitoring of OSF is crucial for malignancy prevention. Objective: This study evaluates the expression of Hypoxia Inducible Factor-1α (HIF-1α) in saliva as a potential biomarker for OSF. Methods: Study was a cross-sectional study conducted in Karachi. The study was completed in 6 months from July 2023 to December 2023 and Sixty-five OSF patients participated in the study, providing saliva samples analyzed for HIF-1α expression using immunohistochemically (IHC). Clinic pathological features, including age, gender, body mass index (BMI), and etiological factors (tobacco, smoking, areca nut), were documented. Relationships between clinical symptoms (burning sensation, pain, ulceration, and dry mouth), fibrosis severity, and HIF-1α staining intensity in blood vessels and fibroblasts were assessed. Results: The study population included 68.3% males and 31.7% females, with a mean age of 32.56±4.12 years. Tobacco use (47.7%) was the most common etiology. HIF-1α expression was significantly elevated in fibroblasts compared to blood vessels, with mild staining in 54.2% of blood vessels and 49.8% of fibroblasts. Increased HIF-1α expression correlated with more severe OSF symptoms, indicating a higher risk of malignant transformation. Conclusion: HIF-1α is a promising biomarker for early diagnosis and assessment of malignant potential in OSF. Early detection and monitoring could improve clinical management and reduce OSCC risk, warranting further research for validation and therapeutic targeting.

Microstomia- A Review Of Published Case Reports On The Proposed Management Of Microstomia

Introdcution: microstomia, or the reduction of oral opening, can indeed present challenges for patients across various contexts, from eating and speech to prosthetic treatment. It's essential for clinicians to understand the underlying causes and tailor their approach accordingly. By synthesizing existing evidence, this review aims to provide insights into the effectiveness and feasibility of different prosthetic interventions, thereby guiding clinicians in their decision-making process for optimal patient care. Materials and methods: published case reports and case series reporting on prosthetic rehabilitation of microstomia patients were included in the present review. Only cases with a reduction in the size of the oral aperture were included, and cases with reduced mouth opening with a normal oral aperture (e.g., oral submucous fibrosis, temporal-mandibular joint ankylosis, etc.) Were excluded. Case reports: (case report1) a 93-year-old woman without teeth was referred from the local hospital to the department of oral rehabilitation at the faculty of dentistry, university of otago, dunedin, new zealand. The woman's surgeries on her lower lip resulted in a significant reduction in the vertical opening distance between her upper and lower lips, now at 30 mm. This condition, known as microstomia. (case report 2) a 62-year-old male patient, completely without teeth, presented to the prosthodontic department due to functional difficulties. Discussion: a planned and step-by-step approach is crucial when dealing with cases of microstomia. The outcome greatly depends on the complexity of the case and the utilization of recommended materials and equipment hence, diagnosis and treatment planning play pivotal roles in the management process. Conclusion: although the utilization of flexible denture materials holds promise in enhancing patient comfort and treatment outcomes, further research is warranted to evaluate their long-term success rates. Longitudinal studies can furnish valuable insights into the durability, stability, and overall performance of these materials over time, assisting clinicians in decision-making and optimizing patient care.

Exploring the role of angiogenesis in fibrosis and malignant transformation in oral submucous fibrosis: a systematic review and meta-analysis.

Angiogenesis is a crucial molecular driver of fibrosis in various inflammatory lesions. Oral submucous fibrosis (OSMF) is a chronic inflammatory fibrotic disorder with malignant potential. The angiogenetic pathways in OSMF remain obscure due to limited research, necessitating an in-depth review. This review aimed to illuminate the cryptic pathogenetic mechanisms of angiogenesis in the disease progression/fibrosis of OSMF and its malignant transformation, providing insights for improved treatment. Extensive literature searches were conducted across an array of databases until October 2023. Original research articles on angiogenesis in OSMF were included, and the risk of bias was assessed using the modified Newcastle-Ottawa scale. RevMan ver. 5.4 (Cochrane Collaboration) was used for data analysis. Thirty-four articles were included for qualitative synthesis and seven for quantitative analysis. Findings revealed that angiogenesis was significantly increased in early-stage OSMF but decreased as the disease advanced. It was also associated with the severity of epithelial dysplasia and malignant transformation. A random-effects model confirmed the upregulation of angiogenesis as a significant risk factor in early-stage fibrosis and malignant transformation. The mounting evidence reinforces that angiogenesis plays a crucial role in the progression of early-stage fibrosis of OSMF and its malignant transformation, opening avenues for diagnostic and therapeutic interventions.

MIAT promotes myofibroblastic activities and transformation in oral submucous fibrosis through sponging the miR-342-3p/SOX6 axis.

Oral submucous fibrosis (OSF) is an oral potentially malignant disorder that is closely related to the habit of areca nut chewing. Long non-coding RNA (lncRNA) myocardial infarction-associated transcript (MIAT) has been identified as an essential regulator in the fibrosis progression. However, the role of MIAT in the development of OSF remains unknown. The transcriptomic profile showed that MIAT is significantly overexpressed in the OSF cohort, with a positive correlation to fibrotic markers. The silencing of MIAT expression in primary buccal mucosal fibroblasts (BMFs) markedly inhibited arecoline-induced myofibroblast transformation. Mechanistically, MIAT functioned as a miR-342-3p sponge and suppressed the inhibitory effect of miR-342-3p on SOX6 mRNA, thereby reinstating SOX6 expression. Subsequent RNA expression rescue experiments confirmed that MIAT enhanced resistance to apoptosis and facilitated myofibroblastic properties such as cell mobility and collagen gel contraction by regulating the miR-342-3p/SOX6 axis. Taken together, these results suggest that the abnormal upregulation of MIAT is important in contributing persistent activation of myofibroblasts in fibrotic tissue, which may result from prolonged exposure to the constituents of areca nut. Furthermore, our findings demonstrated that therapeutic avenues that target the MIAT/miR-342-3p/SOX6 axis may be a promising approach for OSF treatments.

MicroRNA-503 Suppresses Oral Mucosal Fibroblast Differentiation by Regulating RAS/RAF/MEK/ERK Signaling Pathway.

The abnormal proliferation and differentiation of oral mucosal fibroblasts (FBs) is the key to the progression of oral submucosal fibrosis. To clarify the mechanism of platelet-derived growth factor (PDGF-BB)-induced FBs fibrosis in oral mucosa, real-time quantitative polymerase chain reaction and Western blot were used in this study to detect the expression of miR-503 and the expression of p-MEK, p-ERK, miR-503, RAF, smooth actin and type I collagen under different time and concentration stimulation of PDGF-BB. The effects of overexpression of miR-503 or RAF on the proliferation and migration of FBs were detected by cell counting kit 8 and cell scratch assay, respectively. A dual luciferase reporter gene assay was used to verify the targeting effect of miR-503 on RAF. The results showed that miR-503 was downregulated in a dose- and time-dependent manner in PDGF-BB-induced FBs. In addition, RAF is a direct target of miR-503 and can be negatively regulated. Overexpression of RAF can promote FB proliferation, migration, differentiation, collagen synthesis, and activation of downstream molecules (MEK/ERK), while overexpression of miR-503 can partially reverse the effects of RAF. Therefore, miR-503 regulates the biological behavior of PDGF-BB-induced oral mucosal FBs by influencing the activation of the RAS/RAF/MEK/ERK signaling pathway.

MiRNA99a as a Potential target in P13K/Akt1/mTOR signaling pathway in progression of OSCC

BackgroundOral cancer presents a significant global health challenge, driving ongoing research to enhance diagnostics and treatments. MicroRNAs, particularly miRNA99a, have emerged as key players in oral cancer's initiation, progression, and advanced development. However, their precise molecular mechanisms remain unclear. We analyze miRNA99a in modulating the PI3K/Akt1/mTOR signaling pathway within oral squamous cell carcinoma through in silico data analysis. Additionally, we examined miRNA99a levels in both oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC). Materials and MethodsA comprehensive approach utilizing various insilico tools identified potential target genes regulated by miRNA99a and examined their interactions within the PI3K/Akt1/mTOR signaling pathway. The study involved meticulous screening, functional enrichment analyses, and network analyses to understand the regulatory networks influenced by miRNA99a. Additionally, RT-PCR was used to measure the CT levels of miR-99a in OSMF, OSCC and NM samples. ResultsThe analysis revealed a cohort of putative target genes regulated by miRNA99a, demonstrating their involvement in crucial cellular processes linked to OSCC progression. Functional enrichment analyses highlighted the significant association of these target genes with the PI3K/Akt1/mTOR pathway, indicating their potential impact on pivotal oncogenic signaling pathways. Network analyses revealed complex regulatory networks orchestrated by miRNA99a, its action within the PI3K/Akt1/mTOR signalling pathway and influencing OSCC development. RT-PCR analysis revealed a significant downregulation of miR-99a in OSCC and OSMF samples compared to NM, with mean CT values of 39.0940 and 38.3986 respectively, versus 33.7540 in NM (p = 0.000). ConclusionmiRNA99a's potential as a crucial regulator of the PI3K/Akt1/mTOR pathway in OSCC. The identified target genes and their interactions offer a foundation for further experimental validations, presenting opportunities for discovering novel therapeutic avenues or prognostic markers in managing OSCC. Integrating multi-omics data reinforces the significance of miRNA99a-mediated regulatory mechanisms in the intricate landscape of oral cancer biology.

Molecular profiling of oral epithelial dysplasia and oral squamous cell carcinoma using next generation sequencing

BackgroundNext generation sequencing (NGS) is a massive, high-throughput sequencing technology used to analyze various mutations and genetic changes in cancer. Oral squamous cell carcinoma (OSCC) is the most common malignancy of the head and neck region. OSCC usually arises from oral potentially malignant disorders, like oral leukoplakia, oral submucous fibrosis and erythroplakia, and shows mutation of tumor suppressor genes, and several other critical genes involved in apoptotic pathways, cell migration, and cell growth. AimTo analyze the molecular profiles of oral epithelial dysplasia and different grades of oral squamous cell carcinoma using NGS in the Indian subpopulation. Methodology21 patients (5 patients each of well differentiated, moderately differentiated, poorly differentiated squamous cell carcinoma, severe epithelial dysplasia, and 1 normal appearing mucosal tissue from apparently healthy individuals) were included in the study. Next generation sequencing was carried out using 50 hotspot gene panel. Protein-protein analysis was carried out using STRING Consortium 2023 and the methylation profile of the expressed genes was evaluated using the UALCAN portal. ResultsSevere epithelial dysplasia showed TP53 (c.743G>A, p.R248Q) pathogenic mutations (SNV) in suboptimal QC parameters. Well differentiated squamous cell carcinoma showed TP53 (c.328delC, p.Arg110fs*13), APC (c.4135G>T, p.Glu1379*), and FBXW7 (c.832C>T, p.Arg278*) mutations. CTNNB1 (c.134C>T, p.Ser45PheS45F), TP53 (c.637C>T, Arg213TerR213*), NRAS (c.183A>C, p.Gln61HisQ61H) and PDGFRA (c.1672C>T, p.Arg558Cys) mutations were seen in moderately differentiated squamous cell carcinoma. No pathogenic mutations were evident in poorly differentiated squamous cell carcinoma. STRING analysis showed that all the expressed proteins in each group were interrelated to each other. No significant difference was evident in the methylation profile of all the expressed genes when compared to the normal controls. ConclusionThe results obtained in this study explain the diverse genetic mutations in various grades of oral squamous cell carcinoma. Identification of these mutations would help in providing better treatment, designing a proper treatment plan for the patients with OSCC and support minimal intervention medicine.

IMPLANT PLACEMENT IN ORAL SUBMUCOUS FIBROSIS (OSMF) AND TRISMUS PATIENTS WITH RESTRICTED MOUTH OPENING

IMPLANT PLACEMENT IN ORAL SUBMUCOUS FIBROSIS (OSMF) AND TRISMUS PATIENTS WITH RESTRICTED MOUTH OPENING

Psychological problems and their impact on oral mucosal disease patients’ quality of life: A cross-sectional study in the Chinese population

ObjectivesWe aimed to investigate the presence of common psychological factors (i.e., stress, depression, anxiety) and their impact on the Oral health-related quality of life (OHRQoL) in patients diagnosed with four oral mucosal diseases (OMDs): recurrent aphthous ulcers (RAU), oral lichen planus (OLP), oral leukoplakia (OLK), and oral submucous fibrosis (OSF). MethodsA total of 229 patients with clinically diagnosed OMDs were enrolled in this study, consisting of 55 RAU, 68 OLK, 50 OLP, and 56 OSF patients. The patients were statistically analyzed for psychological problems and OHRQoL using the Visual Analog Scale (VAS)､ the 5-item Oral Health Impact Profile (OHIP-5) and the Depression Anxiety Stress Scale-21 (DASS-21) scales. ResultsThere were 229 valid questionnaires collected, consisting of 83 females and 146 males with a mean age of 45.24 (SD = 11.88) years. Multiple regressions between DASS-21 scores and OHIP-5 scores revealed generally negative impacts of psychological problems on OHRQoL, with depression on OLP (β = 0.47), OLK (β = 0.65) and OSF (β = 0.38), stress on RAU (β = 0.29), OLP (β = 0.72), OLK (β = 0.38) and OSF (β = 0.60), and anxiety on OLP (β = 0.33), OLK (β = 0.49) and OSF (β = 0.51). ConclusionsPsychological problems like depression, stress, and anxiety were found to be prevalent in OMDs patients and adversely affected their OHRQoL. The results support the biopsychosocial medical model in the treatment of OMDs patients. Clinical significanceThe present study reinforced the crucial roles of psychological factors in impacting OMDs patients' OHRQoL. Therefore, it is necessary to monitor patients’ psychological status and OHRQoL using questionnaires like DASS-21 and OHIP-5. Followed by psychological interventions, the treatment is expected to be enhanced.

High-resolution AI image dataset for diagnosing oral submucous fibrosis and squamous cell carcinoma

Oral cancer is a global health challenge with a difficult histopathological diagnosis. The accurate histopathological interpretation of oral cancer tissue samples remains difficult. However, early diagnosis is very challenging due to a lack of experienced pathologists and inter- observer variability in diagnosis. The application of artificial intelligence (deep learning algorithms) for oral cancer histology images is very promising for rapid diagnosis. However, it requires a quality annotated dataset to build AI models. We present ORCHID (ORal Cancer Histology Image Database), a specialized database generated to advance research in AI-based histology image analytics of oral cancer and precancer. The ORCHID database is an extensive multicenter collection of high-resolution images captured at 1000X effective magnification (100X objective lens), encapsulating various oral cancer and precancer categories, such as oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC). Additionally, it also contains grade-level sub-classifications for OSCC, such as well- differentiated (WD), moderately-differentiated (MD), and poorly-differentiated (PD). The database seeks to aid in developing innovative artificial intelligence-based rapid diagnostics for OSMF and OSCC, along with subtypes.

Role of a Novel Device, “DrOroscope,” in the Early Diagnosis of Oral Potentially Malignant Disorders and Dysplasia – A Case Series

Abstract Early identification of oral cancer is essential for increasing survival rates and improving the quality of life after treatment. Specialized diagnostic tools such as VELscope, ViziLite, Identafi, and DrOroscope have been created to precisely evaluate the lesions and minimize morbidity. The DrOroscope is a small, easily transportable, and cost-effective diagnostic tool created for the analysis of different premalignant and malignant diseases without requiring invasive methods. In the present case series, a DrOroscope was used. The case series includes oral submucous fibrosis with and without dysplasia and erythroplakia. The image analyses given by the DrOroscope were concordant with the histopathological reports. The DrOroscope can be used as reliable noninvasive supplemental tool along with the comprehensive oral examination in diagnosing potentially malignant disorders, dysplasias, and malignancies.

Cytotoxicity in Tobacco Chewers: Insights from Buccal Cytome Analysis in Botad, Gujarat: A Cross-Sectional Study

Introduction: Oral submucous fibrosis (OSMF) is a significant public health concern linked to tobacco consumption, particularly affecting rural populations in Gujarat. This condition, which can lead to serious health complications, underscores the urgent need for awareness and intervention strategies in these areas. The primary aim of this study was to investigate the prevalence of OSMF among tobacco chewers in rural Botad, focusing on identifying cellular abnormalities through buccal cytome analysis. Materials and Methods: A proforma-based approach was employed to collect data from OSMF patients. The study included buccal cytome analysis to assess cellular abnormalities among tobacco chewers, with a particular focus on those consuming mava and pan masala. Additionally, physical observations were made to correlate perinatal health with pre-cancerous lesions. Results: The findings revealed a predominance of OSMF in male patients from rural areas, highlighting a significant lack of awareness regarding the risks associated with tobacco use. Buccal cytome analysis indicated notable cellular abnormalities, especially among mava and pan masala consumers, suggesting heightened cytotoxicity. The study also found major abnormalities in tobacco chewers using lime. Conclusion: This study underscores the critical need for early detection, intervention, and public health initiatives to combat the prevalence and adverse effects of OSMF among tobacco chewers in rural Botad. Addressing this preventable condition is essential for improving community well-being and reducing the burden of tobacco-related health issues..

Comprehensive analysis of clinicopathological characteristics in oral squamous cell carcinoma arising from oral submucous fibrosis: a retrospective study

BackgroundOral squamous cell carcinoma arising from oral submucous fibrosis is recognized as a clinicopathologically distinct disease. This study aims to summarize and compare the population and clinicopathologic characteristics of OSCC-OSF with other OSCC in Hunan Province, China. The objective is to formulate treatment strategies more in line with regional characteristics.MethodsA retrospective review of OSCC cases recruited from the Second Xiangya Hospital from 2010 to 2020 was conducted. A total of 1,413 OSCC patients were selected, including 481 patients with OSCC-OSF and 932 were other OSCC. Population characteristics, risk factors and clinicopathological manifestations were explored in OSCC-OSF and other OSCC, as well as thinprep cytologic test and DNA quantification.ResultsWe found that OSCC-OSF patients were younger than those with other OSCC. Both types of disease were predominantly observed in males compared to females. Tumor biopsy analysis indicated that tumor cells within OSCC-OSF patients were more likely to be well differentiated and showed a higher frequency of lymph node metastases. Clinicopathological factors, such as the chewing betel nuts habit and smoking, were more prevalent in OSCC-OSF patients in contrast to other OSCC. DNA quantification revealed that the number of DNA aneuploid cells was higher in OSCC-OSF compared to other OSCCs.ConclusionIn this study, OSCC-OSF is considered a clinicopathologically distinct disease. Compared with other OSCC, OSCC-OSF patients have a higher incidence of nodal metastases, an early clinical TNM stage, and a lower three-year survival rate. Therefore, early diagnosis and treatment are crucial to improving the prognosis of OSCC-OSF.

Serum mRNA levels of cytokeratin-19 and vascular endothelial growth factor in oral squamous cell carcinoma and oral potentially malignant disorders using RT-PCR

BackgroundOral cancers, which include tumors of the oral cavity, salivary glands, and pharynx, are becoming increasingly prevalent worldwide. Squamous cell carcinoma accounts for over 90% of malignant oral lesions, with oral squamous cell carcinoma (OSCC) being notably common in the Indian subcontinent and other regions of Asia. This is especially true in South-Central Asia, including Sri Lanka, where it is particularly prevalent among men. This study aims to evaluate the levels of Vascular Endothelial Growth Factor-A (VEGF-A) and Cytokeratin-19 (CK-19) mRNAs in whole blood as a potential method for the early detection of OSCC.MethodsThe study included 40 patients (each from OSCC, Oral Submucous Fibrosis (OSF), Oral Leukoplakia (OLK), Oral Lichen Planus (OLP), and 10 healthy controls. The expression levels of VEGF-A and CK-19 mRNAs were measured from extracellular RNA extracted from whole blood samples using real-time reverse transcription polymerase chain reaction (RT-PCR) with sequence-specific primers. Receiver operating characteristic (ROC) curve analysis was used to evaluate the effectiveness of these biomarkers in detecting OSCC.ResultsThe results demonstrated a significant increase in blood transcripts of the candidate mRNAs CK-19 and VEGF-A in patients with OSCC, OSF, OLK, and OLP. The Wilcoxon signed-rank test revealed a p-value of 0.002 for each specific comparison between diseased patients and healthy controls (i.e., OSCC vs. HC, OSF vs. HC, OLP vs. HC, OLK vs. HC) for both CK-19 and VEGF-A. When these two biomarkers were used together, they provided a 60% predictive probability for patients with OSCC (p = 0.023).ConclusionThis study highlights the efficacy of blood mRNA transcriptome diagnostics in detecting OSCC. This innovative clinical approach has the potential to be a robust, efficient, and reliable tool for early cancer detection. Blood-based transcriptomes could be further explored for their effectiveness in various health contexts and for routine health monitoring.

Emerging roles of the renin-angiotensin system in select oral diseases.

The renin-angiotensin system (RAS) plays essential roles in cardiovascular and renal function regulation. Recent studies have shown that the RAS components are widely expressed in oral tissues, but their roles in oral diseases remain underexplored. This review aims to summarize the effects of the RAS in select oral diseases including oral squamous cells carcinoma (OSCC), periodontitis, oral submucous fibrosis (OSF), and ageusia/dysgeusia. Data searches were performed using PubMed, Web of Science and Scopus through July 2024. A narrative overview of current literature was undertaken to synthesize the contexts with elaboration and summary. In OSCC, ACE/Ang II/AT1R promotes OSCC by inducing angiogenesis, cell proliferation and invasiveness. Conversely, ACE/Ang II/AT2R and ACE2/Ang (1-7)/MasR inhibit OSCC progressions. In periodontitis, ACE/Ang II/AT1R upregulates inflammatory cytokines and promotes osteoclast differentiation factor RANKL, whereas ACE2/Ang (1-7)/MasR exerts opposite effects by preventing inflammation and alveolar bone loss. In OSF, Ang (1-7) counters the profibrotic and proinflammatory action of Ang II. In dysgeusia, Ang II suppresses salt taste responses and enhances sweet taste sensitivities, while Ang (1-7) exhibits opposite effects. The RAS cascade plays crucial roles in OSCC, periodontitis, OSF and ageusia/dysgeusia. The imbalanced RAS may aggravate the progression of these diseases.