Potentially Malignant Disorders Research Articles

Single-cell transcriptome dissecting the microenvironment remodeled by PD1 blockade combined with photodynamic therapy in a mouse model of oral carcinogenesis.

Oral squamous cell carcinoma (OSCC) stands as a predominant and perilous malignant neoplasm globally, with the majority of cases originating from oral potential malignant disorders (OPMDs). Despite this, effective strategies to impede the progression of OPMDs to OSCC remain elusive. In this study, we established mouse models of oral carcinogenesis via 4-nitroquinoline 1-oxide induction, mirroring the sequential transformation from normal oral mucosa to OPMDs, culminating in OSCC development. By intervening during the OPMDs stage, we observed that combining PD1 blockade with photodynamic therapy (PDT) significantly mitigated oral carcinogenesis progression. Single-cell transcriptomic sequencing unveiled microenvironmental dysregulation occurring predominantly from OPMDs to OSCC stages, fostering a tumor-promoting milieu characterized by increased Treg proportion, heightened S100A8 expression, and decreased Fib_Igfbp5 (a specific fibroblast subtype) proportion, among others. Notably, intervening with PD1 blockade and PDT during the OPMDs stage hindered the formation of the tumor-promoting microenvironment, resulting in decreased Treg proportion, reduced S100A8 expression, and increased Fib_Igfbp5 proportion. Moreover, combination therapy elicited a more robust treatment-associated immune response compared with monotherapy. In essence, our findings present a novel strategy for curtailing the progression of oral carcinogenesis.

Evaluating the role of CD44 in oral squamous cell carcinoma and potentially malignant disorders – An immunohistochemical study

BackgroundOral squamous cell carcinoma (OSCC) accounts for 84–97 % of all cases of oral cancer. Oral submucous and leukoplakia are examples of potentially malignant disorders (PMDs) that are signs of the preclinical stage of oral cancerCD44 (Cluster of differentiation) is a cell surface glycoprotein that serves as a Cancer Stem Cell marker. AimThe purpose of the study was to look at the presence of CD44 immunohistochemically in oral epithelial dysplasia, oral submucous fibrosis, and OSCC and how it influences a patient's prognosis. Materials and methodsIn this retrospective study, the expression of CD44 were evaluated in 60 paraffin –embedded specimens (20 OSCC, 20 Dysplasia, 20 OSMF). This study was evaluated by spss 21. Differences in the mean number of CD 44-positive cells per field among epithelial dysplasia, oral submucous fibrosis and squamous cell carcinomas were assessed using one-way ANOVA and comparison between the groups were analysed by using Bonferroni post hoc test. Statistical significance was at P < 0.05. ResultsOn comparing the CD44 immuno-expression, the highest expression was seen in OSCC followed by dysplasia and OSMF. The OSCC group had a high mean total score of 7.90, followed by dysplasia at 5.40 and OSMF at 5.05. ConclusionAccording to our research, there was a discernible pattern of elevated CD44 expression in OSCC relative to OSMF and dysplasia. These findings set the premise for further research to better outline the role of CD44 in the diagnosis of OSCC.

A prospective study to evaluate the efficacy of a fluorescence based hand-held device in the detection of malignant and potentially malignant disorders (PMD) of the oral cavity

ObjectiveOral cancers have varied clinical presentations, often leading to repeated and multiple biopsies to establish diagnosis and formulate treatment. Use of portable, office- based tools to help in diagnosis and biopsies can result in early diagnosis. We used a fluorescence-based device to study its efficacy in malignant and potentially malignant disorders of oral cavity. Method50 individuals including 41 patients and 9 controls were enrolled. Following a thorough clinical examination, the Oralscan® device (with combined autofluorescence and diffuse reflectance) was used for characterization of these lesion and to assist in biopsy taking. The zones (red/yellow/green) in which the lesion(s) fell were noted. Punch biopsies were performed and pathological reports were compared with the zonal category as given by the device. ResultsThe most common site of involvement was buccal mucosa (70.7 %). The total number of lesions studied was 59, with 143 images captured in toto. 75.6 % of cases were malignant. The overall sensitivity, accuracy and PPV of the device was 43.24 %, 34.04 % and 61.54 % respectively. ConclusionThe present study showed that the use of the autofluorescence and diffuse reflectance handheld device had poor sensitivity and specificity for diagnosing oral lesions both malignant and potentially malignant disorders of oral cavity.

EFFECT OF BETEL NUTS AND TOBACCO DERIVATIVES ON ANTIOXIDANTS AND MICRONUTRIENTS IN ORAL SUBMUCOUS FIBROSIS AND ORAL CANCER PATIENTS IN GUJARAT POPULATION

Objective: In our previous study, we have find the significance of biochemical markers between precancerous and cancerous subject with normal healthy individuals in Gujarat population, taking into consideration the severity of biochemical markers in cancerous condition. We felt that other than comparison, effect of betel nuts and tobacco derivatives on antioxidants and micronutrients has required further evaluation to develop a better understanding. The objective of the present study is to measure the interdependence of antioxidants and micronutrients in oral submucous fibrosis and oral cancer patients and find its significance. Method: In this study, a total of 150 patients in which 50 diagnosed PMD patients and 50 diagnosed oral cancer patients with 50 healthy non-tobacco consuming were selected as a control group. Five to seven milliliters of venous blood was collected under aseptic precautions with patients consent. All the parameters were analyzed by standard methods using fully auto-analyzed with a ready-to-use kit. Result: This research was conducted on 150 patients, out of which 50 diagnosed potential malignant disorder patients and 50 oral squamous cell carcinoma patients matched with 50 healthy control individuals. Average age of patients with PMD and OSCC was 55.6±9.74-and that of control group was 35.83±8.90 years. Student t-test showed that there was a significant difference between the two groups with regard to age. Of the 100 patients with PMD, 72 (72% of total) were men and 28 (28% of total) were women. Among the individuals in the control group (n=50), 35 persons (70% of total) were men and 15 (30% of total) were women. Chi-square test showed that there was no significant difference between the two groups in terms of sex (p=0.891). The copper levels of PMD and OSCC, respectively, were 153.57±7.68 and 164.43±15.75. The value was statistically compared with OSCC which had significantly higher levels than healthy control (102.53±22.1). The iron levels of PMD and OSCC, respectively, were 77.62±15.27 and 50.04±19.97. The value was statistically compared with OSCC which had significantly lower levels than (138.4±13.2) healthy control. The Vitamin C levels of PMD and OSCC, respectively, are 0.55±0.10 and 0.44±0.9. The value was statistically compared to the OSCC which had significantly lower than 1.09±0.17 control. The Vitamin E levels of PMD and OSCC, respectively, 1.18±0.16 and 0.8±0.12 values were statistically compared the OSCC which had significantly lower levels than (1.39±3.64) healthy control. Conclusion: In our finding, Vitamin C showed positive correlation with serum iron and serum copper with malignant disorders. Trace elements and antioxidants exhibited interdependence in both physiologic and pathologic states such as oral cancer.

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.

Study of expression of GLUT-1 in oral potentially malignant disorders and oral squamous cell carcinoma: An immuno-histochemical analysis.

Glucose is the chief source of energy for cells, and glucose transporter 1 (GLUT-1) is one of the most common glucose transporters in humans. Tumour cells are known to express hypoxia-related protein, and these may allow tumour cells to survive under a sustained hypoxic environment. Surviving cells develop a more aggressive phenotype, which results in poor prognosis. Expression and comparison of GLUT-1 in normal tissues, potentially malignant disorders (PMDs), and oral squamous cell carcinoma (OSCC) and comparison of expression in different grades of OSCC. A total of 57 cases (10 normal, 17 PMD, and 30 cases of OSCC) were stained immuno-histochemically with GLUT-1. The expression was scored as 0, 1, 2, 3, and 4 for negative, mild, moderate, severe, and intense staining, respectively. GLUT-1 expression was detected in all grades of OSCC. A significant correlation was found on comparing normal and OSCC, normal and PMDs, and PMD and OSCC. The expression of GLUT-1 was significant when compared with different histopathological grades of OSCC. Expression of GLUT-1 increased from normal to PMDs to increasing grades of OSCC and hence can be used as a prognostic predictive marker for OSCC.

Salivary cortisol levels in patients with potentially malignant oral disorders and oral mucosal cancer: a case-control study.

The relationship between salivary cortisol secretion and the presence of cancer in the oral cavity has not been completely clarified. Due to this, we proposed carrying out a study to determine salivary cortisol levels in patients with potentially malignant disorders (PMD), oral squamous cell carcinoma (OSCC) and healthy individuals. Cross-sectional case-control study, among 80 patients seen at the Faculty of Dentistry of the National University of Rosario, Argentina, between January 2018 and April 2020. 40 cases represented by Leukoplakia, Lichen, Erythroplakia and SCC and 40 controls were included. Smoking habit and alcohol consumption were included. The presence of stress was determined. Morning salivary cortisol levels were measured with the Roche electrochemiluminescence method (Traceability: St by ID-MS). Patients with SCC presented elevated salivary cortisol values. Individuals with stage III tumors showed levels higher than 8.74 ng/ml in all cases. A significant association between cortisol levels and stress was detected in patients in the control group (p<0.005) and in individuals with PMD (p=0.009). This association was not significant in patients with SCC (p=0.999). After applying the logistic regression method, when adjusting odds ratios according to tobacco and alcohol consumption and the presence of stress, the association between cortisol levels and presence of stress was highly significant (p<0.001). The possibility of presenting undetectable cortisol results was 94% lower in patients with stress. The increase in salivary cortisol levels in patients with PMD and SCC, is related to stress conditions, being able to generate alterations tending to immunosuppression of the cellular microenvironment.

Evaluation of Serum Vitamin D and IL-1ß in Patients with Oral Lichen Planus and Healthy Subjects: A Research Protocol

Introduction: Oral Lichen Planus (OLP) is a chronic mucocutaneous immune-mediated disease that has been classified as a Potentially Malignant Disorder (PMD). The aetiology of OLP needs further exploration. Research indicates that the immune system plays a pivotal role in the progression of OLP. Need for the study: Vitamin D regulates the suppression of Interferon-Gamma (IFN-γ) and Interleukin-1 beta (IL-1β) production within the epithelium and its insufficiency may play a role in the development of OLP. Aim: To evaluate and compare the serum concentrations of IL-1β and Vitamin D in patients affected by OLP and in healthy subjects. Materials and Methods: A case-control study will be conducted in the Department of Oral Medicine and Radiology at Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, located in Maharashtra, India, from August 2024 to August 2026. Patients who present to the Department of Oral Medicine and Radiology and express willingness to participate will be enrolled in the study. Each patient will undergo a comprehensive clinical examination and provide written consent after being informed about the study. A thorough intraoral clinical assessment of the lesions will be conducted. Once a patient is clinically diagnosed with OLP, serum sample collection will be performed. Similarly, healthy subjects who are willing to participate in the study will also undergo sample collection. The median cubital vein will be punctured to obtain 2.5 mL of blood under aseptic conditions. The electrochemiluminescence-binding assay will then be conducted to quantify the total amounts of 25- hydroxy vitamin D and Interleukin-1 beta. After sample collection, patients with OLP will be educated and counseled regarding the treatment of OLP and habit cessation. Statistical analysis will be performed using an unpaired t-test, with a p-value considered significant at a 5% level of significance.

DNA Image Cytometry for Screening the Carcinogenetic Risk of Oral Potential Malignant Disorders.

Background: Oral Submucosal Fibrosis (OSF) and Oral Leukoplakia (OLK) are well-known oral potentially malignant disorders, and cases of Oral Submucosal Fibrosis concomitant Oral Leukoplakia (OSF+OLK) are now being reported clinically. DNA image cytometry is an objective and non-invasive method for monitoring the risk of precancerous lesions in the oral cavity. Methods: A total of 111 patients with clinically characterized oral mucosal lesions underwent simultaneous and independent histopathological and DNA imaging cytometry assessments. Clinical data were also collected for each patient. Results: The frequency of DNA content abnormality was higher in the tongue than in other oral sites (P = 0.003) for OLK. The frequency of DNA content abnormality was higher in the tongue than in other oral sites (P = 0.035) for OSF+OLK. The differences of DNA content abnormality in age, sex, dietary habit, smoking, and alcohol intake were not observed in OLK and OSF+OLK. The study indicates an association between DNA content abnormality and pathological examination in OSF+OLK ( χ2 test, P = 0.007). OLK showed higher sensitivity and specificity than OSF, while the sensitivity and specificity of OSF+OLK are higher than OLK only and OSF only. Conclusion: DNA image cytometry can be utilized as an adjunctive device for the initial detection of oral potentially malignant disorders that require further clinical management.

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

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

Polymorphisms associated with oral clefts as potential markers for oral pre and malignant disorders.

To investigate whether genes in the Wnt pathway, which have been previously associated with both oral clefts and oral squamous cell carcinoma, are also associated with oral potentially malignant disorders (leukoplakia, erythroplakia and lichen planus). Case-control study: Dataset consisted of clinical information linked to DNA samples from affected subjects diagnosed with oral potential malignant disorders and oral cancer and their matched controls. Individual samples, clinical history, and potential risk factors were obtained through the Dental Registry and DNA Repository project of the School of Dental Medicine, University of Pittsburgh. The rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 (AXIN2) were tested. After genomic DNA had been extracted, genotyping was performed blindly to clinical diagnosis status. Representation of genotypes and alleles in affected subjects in comparison to the unaffected individuals was determined using PLINK. Additional analysis was performed to investigate associations between environmental (socioeconomic/lifestyle) risk factors and the oral pathologies studied using STATA. Two of the SNPs tested (rs9879992 in GSK3B and rs3923087 in AXIN2) were statistically, significantly associated with the pathologies studied (p = 0.039 and 0.038, respectively). Single-nucleotide polymorphisms in genes in the Wnt pathway were associated with oral potentially malignant disorders.

Evaluation of VEGF, BDNF, TRKB expression in oral epithelial dysplasia, oral verrucous carcinoma and oral squamous cell carcinoma and their role as prognostic indicator.

Oral squamous cell carcinoma (OSCC) is a serious health disease that can lead to a reduced quality of life or even death. It ranks sixth in terms of cancer expansion. It is one of India's primary causes of natural death. In OSCC such potentially malignant Disorders (PMDs) are precancerous lesions with such a high risk of progression. Tumor angiogenesis is a one of the basic biomarkers that may influence the proliferation of a precancerous lesion into the cancerous lesion. Tropomyosin receptor kinase B (TrkB), vascular endothelial growth factor (VEGF), and brain-derived neurotrophic factor (BDNF) also play important roles in carcinogenesis by promoting angiogenesis. The construction of new vessels of blood from existing vasculature is referred as angiogenesis. To get deep insights of immunohistochemistry expression of VEGF, BDNF, and TRKB in oral epithelial dysplasia (OED), verrucous carcinoma (VC), and OSCC. The study included 100 formalin-fixed paraffin-embedded tissue blocks from 20 cases of OED, 20 cases of VC, and 60 cases of OSCC [20 cases of well-differentiated oral squamous cell carcinoma (WD-OSCC), 20 cases of moderately differentiated oral squamous cell carcinoma (MD-OSCC), and 20 cases of poorly differentiated oral squamous cell carcinoma (PD-OSCC). The staining intensity and distribution of VEGF, BNDF, and TrkB were examined and statistically analyzed using analysis of variance (ANOVA), post hoc Bonferroni test, independent t-test, Pearson's Chi-square test, and Pearson's correlation coefficient test. The immunoexpression of VEGF, BDNF, and TrkB was found to be elevated in the order of OEDs, VC, and OSCC. The percentage of positive was highest in PD-OSCC, followed by MD-OSCC and WD-OSCC. Based on our findings, angiogenesis plays a significant role in tumor growth and metastasis. A substantial relationship was discovered between VEGF, BDNF, TrkB expression, and increases in vascularity throughout the transition from OEDs to VCs and OSCCs.

Langerhans cell expression in oral submucous fibrosis: An immunohistochemical analysis.

Langerhans cells (LCs) are dendritic cells (DCs) of the epithelium which play a role in an array of oral lesions from gingivitis to oral cancer. Oral submucous fibrosis (OSMF), a potentially malignant disorder (PMD), is an insidious chronic disease with juxta-epithelial inflammatory changes leading to fibrosis. LCs may play a part in the ongoing inflammatory dysregulation of OSMF. The study was aimed at elucidating the distribution of LCs in varying grades of OSMF. A retrospective study using 18 cases of OSMF, graded using haematoxylin and eosin (H&E)-stained section. Immunohistochemistry was performed using polyclonal anti-CD1a antibodies to identify LCs in six cases of normal tissue and 18 samples of OSMF. The distribution of LCs among the various grades and normal mucosa analysed using Student's t-test. LC population in the OSMF was significantly higher when compared to the normal epithelium (p < 0.001). Within the grades, the advanced stage had more LCs than the other stages. The increase in LCs might indicate the role of antigenic exposure in turn leading to cell-mediated immunity in OSMF. Thus, the fibrosis in OSMF might have a direct link to LCs.

Mouth and oral disease classification using InceptionResNetV2 method

Digital tools have greatly improved the detection and diagnosis of oral and dental disorders like cancer and gum disease. Lip or oral cavity cancer is more likely to develop in those with potentially malignant oral disorders. A potentially malignant disorder (PMD) and debilitating condition of the oral mucosa, oral submucous fibrosis (OSMF), can have devastating effects on one’s quality of life. Incorporating deep learning into diagnosing conditions affecting the mouth and oral cavity is challenging. Mouth and Oral Diseases Classification using InceptionResNetV2 Method was established in the current study to identify diseases such as gangivostomatitis (Gum), canker sores (CaS), cold sores (CoS), oral lichen planus (OLP), oral thrush (OT), mouth cancer (MC), and oral cancer (OC). The new collection, termed "Mouth and Oral Diseases" (MOD), comprises seven distinct categories of data. Compared to state-of-the-art approaches, the proposed InceptionResNetV2 model’s 99.51% accuracy is significantly higher.

Photodynamic Therapy Effects on Oral Dysplastic Keratinocyte Cell Cultures: A Systematic Review

Photodynamic therapy (PDT) represents a therapeutic intervention applied in various pre-malignant and malignant disorders’ treatments. The interaction between a photosensitizer (PS), ideal wavelength radiation, and tissue molecular oxygen activates a series of photochemical reactions liable to produce reactive oxygen species. These highly reactive species allow for the decrease cell proliferation and yield cancerous and pre-cancerous cell death. The aim of this work is to carry out a systematic review to investigate the effects of in vitro PDT for oral potential malignant disorders (OPDM) cell lines. This systematic review was conducted according to the PRISMA protocol, and the PROSPERO registration number was CRD42022362349. An electronic search was performed on the following search engines: PubMed, Embase, and Web of Science. The Population, Intervention, Comparison, Outcomes, and Study design (PICOS) has been applied as the method by which to outline our study eligibility criteria. The QUIN tool was employed to interpret the risk of bias of the included studies. Initially, seventy-five records were retrieved through databases, and after the selection steps, seven items finally met our inclusion criteria. The preliminary search resulted in 75 studies, out of which 22 were found to be duplicates. After reviewing the titles and abstracts of the remaining 53 studies, 45 were rejected as they did not meet the inclusion criteria. Further evaluation of the full texts led to the exclusion of only one article, since the full text was not available. As a result, seven studies were ultimately identified and included in the analysis. The main findings confirm the role of in vitro photodynamic therapy using several photosensitizers as a potential treatment for oral potentially malignant disorders.

Potentiality of Malignant Transformation of Oral Submucous Fibrosis: A Prospective Study

Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder (PMD) which has one of the highest rates of malignant transformation (MT) rate. The aim of this study was to assess the rate of MT of OSMF and to analyze the possible contributory factors such as age, gender, socioeconomic status, habits, various signs and symptoms, and presence of other oral PMDs in a group of OSMF patients attending the Oral Medicine Department. Materials and Methods: Out of 25,200 patients who visited the Outpatient Department of School of Dental Sciences, KIMSDU, Karad, from January 2017 to December 2020, 1342 (5.3%) were diagnosed with OSMF and comprised the study sample, in which 1300 (96.87%) were male and 42 (3.12) were female. All the patients were subjected to incisional biopsy, and clinical diagnosis was confirmed histopathologically. Results: The prevalence of OSMF was 5.3% with male predominance, and majority of OSMF patients were in the age group of 21–30 years. Betel chewer’s mucosa and leukoplakia was the most associated lesion. Out of total 1300 male and 42 female OSMF patients, 897 (69%) and 17 (40.47%) showed epithelial dysplasia, and 61 (4.69%) male and 1 (2.38%) female patients showed signs of MT, respectively. Conclusion: The present study highlights the importance of certain risk factors for OSMF that are associated with an increased chance of MT. There is an urgent need of awareness programs through public–private partnership.

Serum and Saliva LDH Levels in Patients with Habit, Oral Potentially Malignant Disorders (OPMDs), and Oral Squamous Cell Carcinoma (OSCC): A Spectrophotometry Study.

Oral potentially malignant disorders (OPMDs) are chronic lesions or conditions characterized by a potential for malignant transformation. One of the hallmarks of cancer is aerobic glycolysis which confers immortality to cancer cells, correlates with the belligerent behavior of various malignancies, and shows an increase in the expression of lactate dehydrogenase (LDH). The present study was conducted to measure and compare serum and salivary LDH levels in patients with habit, OPMDs and oral squamous cell carcinoma (OSCC) patients, and to evaluate if LDH levels can be used as a biomarker in the progression into potentially malignant disorders (PMDs), the prognosis of OSCC, and to assess if saliva is a better biomarker. Thirty patients of both genders were divided into three groups. Group I had patients with habits, group II had OPMDs, and group III had OSCC with 10 subjects from each group. Saliva and serum of patients were collected according to the standard protocol and measured for LDH using spectrophotometry of 340 nm. Group I had patients with habits, group II had OPMDs, and group III had OSCC. Group I had 6 males and 4 females, group II had 8 males and 2 females, and group III had 7 males and 3 females. The mean serum LDH level in group I was 265.50, in group II was 194.10, and in group III was 224.22. The difference was non-significant (P > 0.05). The mean salivary LDH level in group I was 345.68, in group II was 532.72, and in group III was 1.105. The difference was significant (P < 0.05). Salivary LDH is a non-invasive, cost-effective technique, which can be used as an effective modality for the diagnosis and prognosis of oral cancer as well as for monitoring tobacco users and OPMDs.

RETROSPECTIVE AND OBSERVATIONAL STUDY OF POTENTIALLY MALIGNANT DISORDERS IN A PATHOLOGICAL ANATOMY SERVICE

Objective To evaluate a study population of a pathological anatomy service that was affected by potentially malignant disorders (PMDs), through a retrospective and observational study. Study Design Our study examined 144 cases of PMDs over a 20-year period, analyzing the frequency of such characteristics as age, gender, ethnicity, lesion location, histopathological diagnosis, associated risk factors, and presence of epithelial dysplasia. A follow-up clinical examination was also performed. Results Higher prevalence was observed in white females, in an age group of 61-70 years, and the buccal mucosa was the most affected site. Leukoplakia was the most frequent PMD; associated risk factors, alcohol, and tobacco in male patients were the most prevalent; and six cases of epithelial dysplasia were identified. Thirty-one patients attended the follow-up dental appointment, and 12 exhibited recurrences of oral lesions. Conclusion There is a lack of epidemiological surveys and follow-up clinical examinations for PMDs in Brazil and worldwide for the early detection of lesions. The difficulty in keeping the registration data of public healthcare services up-to-date, as well as low motivation and patient support for prolonged clinical follow-up, were also observed. To evaluate a study population of a pathological anatomy service that was affected by potentially malignant disorders (PMDs), through a retrospective and observational study. Our study examined 144 cases of PMDs over a 20-year period, analyzing the frequency of such characteristics as age, gender, ethnicity, lesion location, histopathological diagnosis, associated risk factors, and presence of epithelial dysplasia. A follow-up clinical examination was also performed. Higher prevalence was observed in white females, in an age group of 61-70 years, and the buccal mucosa was the most affected site. Leukoplakia was the most frequent PMD; associated risk factors, alcohol, and tobacco in male patients were the most prevalent; and six cases of epithelial dysplasia were identified. Thirty-one patients attended the follow-up dental appointment, and 12 exhibited recurrences of oral lesions. There is a lack of epidemiological surveys and follow-up clinical examinations for PMDs in Brazil and worldwide for the early detection of lesions. The difficulty in keeping the registration data of public healthcare services up-to-date, as well as low motivation and patient support for prolonged clinical follow-up, were also observed.

Preliminary Study of the Cancer Stem Cells' Biomarker CD147 in Leukoplakia: Dysplasia and Squamous Cell Carcinoma of Oral Epithelial Origin.

Objectives Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis de novo, as well as through the transformation of oral potential malignant disorders (OPMDs) to oral squamous cell carcinoma (OSCC). The aim of our study was to detect the expression of stemness-type CSC marker CD147 in oral leukoplakias (OLs), the most common OPMD, and OSCCs as well. Materials and methods This study focuses on the semiquantitative immunohistochemical pattern of the expression of the CSCprotein biomarker CD147 in paraffin-embedded samples of 20 OSCCs of different grades of differentiation and 30 cases of OLs without or with different grades of dysplasia, compared to the normal oral epithelium in terms of cells' stain positivity. Statistical analysis wasperformed through Statistical Package for Social Sciences (SPSS) version 25.0(IBM SPSS Statistics, Armonk, NY) with Pearson chi-square test, and the significance level was set at 0.05 (p=0.05). In addition, the study clarified the expression of the respective gene of CD147 through quantitative polymerase chain (qPCR), in paraffin-embedded samples of the two extreme graduations: OLs of mildly dysplastic or non-dysplastic cases (n=10 cases) andOSCCs of moderately/poorly differentiated cases(n=17). Statistical analysis wasthen performed through SPSS version 25.0 with an independent paired t-test, and the significance level was set at 0.05 (p=0.05). Results The gene CD147 was expressed in all cases, although no statistically significant correlations were established. Regarding its protein products, the characteristic membranous staining of CD147 was noticed in the majority of the samples, mostly in the basal and parabasal layers of the epithelium. CD147 was upregulated significantly in the moderately and severely dysplastic OLs than in the mildlydysplastic and non-dysplastic OLs (p=0.008). Also, CD147 was upregulated significantly in the mildly dysplastic and non-dysplastic OLs than in the normal oral epithelium (p=0.012). Discussion The characteristic expression of CD147 in OLs and OSCCs' lesions suggests the presence of stemlike cancer cells, illustrating an underlying effect on the early stages of oral dysplasia, in the OL stage. The clinical application of CD147 as prognostic factor requires the experimental evaluation in larger number of samples. Conclusion Stem cells play an important role in the process of carcinogenesis. A major goal in cancer researchis the identification of specific biomarkers for the detection of cancer stem cells. CD147 is considered as an innovative stem cell marker. Our findings in oral mucosal potentially malignant disorders showed that CD147 is expressed more intenselyin parallel with the progression of the grade of dysplasia in OL.On the other hand, in oral squamous cell carcinoma, CD147 expression remains stable regardless of the degree of differentiation.

Evaluation of crystallization patterns in oral potentially malignant disorders and oral malignancies: A prospective study.

Oral cancers are often detected at late stages, and patients usually had a 50% chance of a 5-year survival rate. Oral cancer usually has an early precancerous stage before its actual malignant transformation. Although there are various approaches to diagnose the early stages of cancer, there is one less explored, cost-effective, and simple technique known as the crystallization test. The aim of the study was to evaluate the crystallization patterns in tobacco users, oral potentially malignant disorders (OPMDs), and oral malignancies. Fifteen patients with oral malignancies, 15 patients with oral potentially malignant disorders, 15 tobacco users, and 15 healthy individuals participated in the crystallization test. Single blood drop was used to perform this test and the obtained crystal patterns were analyzed. This test had a sensitivity of 93.3%, 80.0%, and 20.0% for oral malignancies, oral Potentially Malignant Disorders (PMDs), and tobacco users, respectively. Chi-square analysis revealed a highly significant transverse form between OPMDs and oral malignancies (P < 0.05). Crystallization test was found to be a sensitive, reliable, economical, and less invasive procedure for screening of oral PMDs and oral malignancies under strictly maintained physical conditions.