Prognostic Ability of Expression of Myofibroblasts in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

AIM: To systematically review the existing scientific literature in providing a comprehensive, quantitative analysis on the prognostic ability of Cancer Associated Fibroblasts (CAFs) in Oral Squamous Cell Carcinoma (OSCC) a novel meta-analysis. METHODS: Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO - CRD CRD42023467899. Electronic databases were searched for studies having data on effect of CAFs on overall survival rate and disease prognosis in patients with OSCC, oral epithelial dysplasia (OED) compared to normal healthy controls. Quality assessment of included was evaluated through Newcastle Ottawa scale (NOS) for included studies through its domains. The hazard ratio (HR) and risk ratio (RR) was used as summary statistic measure with random effect model and p value <0.05 as statistically significant. RESULTS: Twenty studies fulfilled the eligibility criteria and were included in qualitative synthesis and eighteen studies for meta -analysis. Included studies had moderate to low risk of bias. It was observed through the pooled estimate that overall survival rate - (HR) =2.30 (1.71 - 3.10) was lesser in group with high CAFs compared to low CAFs while pooled estimate through RR =1.53 (0.73 - 3.19) and RR = 5.72 (2.40 - 13.59) signified that overall survival rate was lower n OSCC patients with high CAF compared to patients with OED and healthy controls. Publication bias through the funnel plot showed asymmetric distribution with presence of systematic heterogeneity indicating presence of publication bias. CONCLUSION: Abundance of CAFs in tumor stroma of OSCC patients is associated with overall poor survival rate and poor disease prognosis. CAFs acts as a good prognostic and therapeutic marker in disease progression and advancements and should be assessed early to reduce patient's mortality and morbidity.

Antifibrotic Effect of Baicalin on Arecoline Induced Human Oral Fibroblast: An In-Vitro Study.

BACKGROUND: Baicalin is a flavonoid obtained from the Chinese herb Scutellaria baicalensis, which has a wide varieties of health benefits and scope to be studied for its therapeutic potential in oral fibrosis. AIM: The aim of the study was to investigate the antifibrotic effect of a Baicalin in arecoline induced human oral fibroblast in vitro setting. MATERIAL AND METHODS: Arecoline and ethanolic extracts of Baicalin were commercially purchased from Sigma-Aldrich. Human oral fibroblasts were cultured and characterized with specific fibroblast markers, and cells were stimulated with arecoline. An MTT assay (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) was executed to determine the half-maximal inhibitory concentration of arecoline and Baicalin. Arecoline-induced cells (25µg/ml) were treated with a non-toxic dose of Baicalin (proliferative dose of 25µg/ml). Cytokine (CCL2, CXCL-8, IL17, IL-beta, and IL-6) and fibrotic marker genes were studied by reverse transcription-polymerase chain reaction (RT-PCR). The inhibitory effect of Baicalin was studied to prove its antifibrotic properties. RESULTS: Arecoline significantly upregulated all inflammatory and fibrotic markers. On treatment with 25µg/ml of Baicalin, all inflammatory and fibrotic markers were inhibited. Arecoline affects fibroblast morphology, supporting the fact that arecoline is cytotoxic to cells. CONCLUSION: Baicalin can be used as an antifibrotic herb to treat OSMF.

Assessment of correlation between clinical staging, functional staging, and histopathological grading of oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a premalignant condition with a greater prevalence in countries such as India. Various classifications have been put forth by multiple authors to determine the clinical, functional, and histopathological grade of the disease. The classification systems have greatly helped to determine the treatment modality for the patients. Understanding the correlation between the various classifications will help us determine the course of the disease, management, and prognosis of OSMF. This study assesses the correlation between clinical, functional, and histopathological grading of OSMF. AIM: To assess the correlation between clinical staging, functional staging, and histopathological grading of OSMF. MATERIALS AND METHODS: Thirty patients with clinical and histopathological diagnosis of OSMF were assigned into clinical stage, functional stage, and histopathological grade. The correlation between these three stages assigned was studied. STATISTICAL ANALYSIS: The degree of agreement between the clinical, functional, and histopathological classifications was quantified by the Weighted Kappa statistics. Correlation between the three classifications was done using Kendall's tau and Spearman's correlation coefficient.There was a good agreement and statistically significant correlation between clinical and functional grading. There was a poor agreement and no significant correlation between clinical and histopathological grading. There was a poor agreement and no significant correlation between functional and histopathological grading.

Assessment of cytogenic damage in the form of micronuclei in oral epithelial cells in patients using smokeless and smoked form of tobacco and non-tobacco users and its relevance for oral cancer.

CONTEXT: Early detection of cytological damages may help in reduction of morbidity and mortality in patients with oral cancer. AIMS: (1) The primary aim of this study is to assess the cytogenic damage in the form of micronuclei (MN) in patients with smokeless and smoked tobacco using habit. (2) The secondary aim of this study is to compare the MN score in patients using tobacco and patients with no tobacco habit. (3) To find out incidence of MN according to duration and frequency of tobacco usage. SETTINGS AND DESIGN: This is a clinical study. MATERIALS AND METHODS: A total of 100 patients each with the habit of smokeless tobacco (SLT) chewing, smoked tobacco usage and with no habit were included in the study. Epithelial cell smears were prepared and slides were stained with Papanicolaou stain. Scoring of at least 1000 cells was done and a MN frequency score was assigned for exfoliated oral mucosal cells. STATISTICAL ANALYSIS: Analysis of variance and post hoc tests were used. RESULTS: The difference between the total number of cells with MN was not appreciable between the smokeless and smoked tobacco groups, though the total number of MN was higher in subjects using SLT. Total number of cells with MN and the total number of MN were significantly lower in non-tobacco users when compared with tobacco users. There was very weak positive correlation between the total number of MN as per the duration and frequency of the tobacco habit. CONCLUSION: The use of smokeless and smoked tobacco are associated with cytotoxic and genotoxic effects. SLT seems to cause more damaging effects than the smoked form.