Premalignant Lesions Of Oral Cavity Research Articles

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

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

Frequency of premalignant lesions of oral cavity in Lyari Town, Karachi.

Introduction: Usage of tobacco in any form and its related products is the chief avoidable reason of death around the globe based on reports published by WHO. Currently, approximately 6 million fatalities occur each year and majority of these deaths, almost 4 out of every 5 fatalities occur in less developed countries around the world.
 Objective: To find out the frequency of premalignant lesion in oral cavity in persons consuming betel nuts and tobacco in Lyari town Karachi, Pakistan.
 Methodology: After Institutional ethical committee approval, this cross-sectional survey was carried out in the routine camps at Bihar colony Lyari town under supervision of ENT and Oral Pathology Departments Sindh Government Lyari Hospital Karachi. Patients fulfilling inclusion criteria and given written informed consent were selected for the study.
 Results: The demographic profile of study participants and it was seen that 15 (5.3%) of them were aged 20 to 30 years, 200 (70.4%) of them were males, 92(32.4%) of them had primary education, 109(38.4)of them were laborers 89(31.3%) of them were Sindhi. The overall frequency of premalignant lesions of oral cavity was found in 28 (9.86%) in study participants. Oral submucous fibrosis (OSF) was seen in 11 (39.3%) of the individuals, 8(28.6%) were having Lichen planus, 5(17.9%) were having leukoplakia, and 4(14.2%) were having erythroplakia.
 Conclusion: Despite the fact that the study found a higher frequency of OPML than earlier studies in this demographic, the proportion of those who used tobacco in any form was significantly higher.
 Keywords: Oral premalignant lesions, screening, risk factors, tobacco use, Betel Quid

Evaluation of extracellular signal regulated kinase 1 expression in premalignant lesions of oral cavity

Background: Most oral squamous cell carcinomas are preceded by premalignant lesions like leukoplakia, erythroplakia etc. Identification of these lesions by molecular markers and intervention at an early stage can reduce mortality, morbidity and cost of treatment associated with oral cancer. Extracellular signal regulated kinase 1 (ERK 1) is one of the various markers involved in carcinogenesis.Methods: We studied the expression of ERK 1 in twenty-five oral premalignant lesion biopsies using immunohistochemistry (IHC) and western blot analysis.Results: Ninety-two percent of premalignant lesions showed positive expression of ERK 1 on IHC and the same were confirmed by western blot analysis. ERK 1 expression was increased in premalignant lesions as compared to peripheral normal tissue but the difference between them was not statistically significant. On comparing the level of expression of peripheral normal and premalignant tissue on IHC, moderate and high level of expressions were significantly higher in premalignant lesions (24%) than peripheral normal tissue (12%).Conclusions: There was an increased expression of ERK 1 in oral premalignant lesions as compared to peripheral normal tissue, although, this difference was not statistically significant.

Clinicohistopathological profile of malignant and pre-malignant lesions of oral cavity

The present study on oral cavity lesions was a descriptive, analytical and observational study consists of total 173 cases, amongst which 38 cases were of pre-malignant lesions while 135 were of malignant lesions. A male preponderance was noted in both pre-malignant and malignant lesions. A maximum number of cases in pre-malignant lesions was from 50-59 years of age group while in case of malignant lesions a bit early age of presentation was noted, i.e. 40-49 years. Most of them were habituated to tobacco—the most common site of involvement for both, oral pre-cancer and cancer was the oral cavity. Leukoplakia was precancerous lesion (55.26%). The variant in the study was verrucous carcinoma. The predominant piece of the oral squamous cell carcinoma was a lot of isolated types. The current review was essentially indistinguishable with various examinations. The study noted a relatively late age of presentation of pre-malignant lesions. This delay could be explained by multiple factors like ignorance and lacking in medical facilities. In this scenario, many patients progress to full-blown malignancy. This examination reflects that there is a tendency to expose issues and instruct individuals concerning unfavourable impacts of liquor and tobacco usage, the significance of dental tidiness, oral self-appraisal and the openness of preventive services organizations.

Outcome of Treatment in Verrucous Carcinoma of Oral Cavity: A Tertiary Rural Hospital Experience.

Verrucous carcinoma of oral cavity is a highly well differentiated variant of squamous cell carcinoma with a low potential for invasion and metastasis. It is prevalent in the tobacco quid chewing population in our region. In this observational study, we reviewed the medical case records of 58 patients treated for oral verrucous carcinoma staged T2 to T4a. All patients underwent wide excision of tumour which included marginal mandibulectomy in 22 and hemimandibulectomy in 23 patients along with neck dissection saving the accessory nerve and internal jugular vein. 5 patients were found to have bone involvement along the alveolar sockets. 11 patients had other associated premalignant lesions in oral cavity. Only 2 patients had lymph node metastasis without extra nodal spread in submandibular region. With a mean follow up of 6years and minimum follow up of 1year, 3 patients had local recurrence. All these 3 patients had bone involvement and 2 of them had lymph node metastasis on histopathological examination. 3 patients who had associated premalignant lesions developed second primary in oral cavity after 3years. In our experience, verrucous carcinoma has good prognosis when treated by surgery. Bone involvement along alveolar sockets and associated oral premalignant lesions adversely affect the outcome. There was no difference in the outcome between selective and modified radical neck dissection. Therefore selective neck dissection (supraomohyoid) would be adequate in treating these patients. Adjuvant radiotherapy can be reserved for T4a lesions or for positive margins.

Photodynamic therapy (PDT) using topically applied delta-aminolevulinic acid (ALA) for the treatment of oral leukoplakia.

Photodynamic therapy (PDT) is a non-invasive method for topical and selective treatment of pre-malignant lesions of oral cavity. The aim of our study was to determine therapeutic response to PDT in patients with oral leukoplakia. Twelve patients participated in our study. Lesions affected a variety of intraoral sites. The most common location was buccal, gingival and mandibular mucosa. Patients were treated with topically applied 10% delta-aminolevulinic acid (ALA) and light from an argon-pumped dye laser. Irradiation was performed in several (6-8) sessions using light at 635 nm wavelength, delivering a total dose of 100 J/cm2 per session. A complete response was obtained in 10 out of 12 treated patients. One recurrence was observed during 6 months. Photodynamic therapy appears to be a feasible alternative to conventional therapy of pre-malignant lesions of oral cavity.