Lipid profile in oral potentially malignant disorders and oral squamous cell carcinoma - A prognostic view.

Introduction: Lipids play an important role in the maintenance of cell integrity. Various tobacco-associated products are known to induce the generation of free radicals and reactive oxygen species, responsible for the high rate of oxidation/peroxidation of polyunsaturated fatty acids. These further release peroxide radicals, causing increased utilization of lipids leading to hypolipidemia. Aim: The aim of this study was to evaluate and compare the lipid profile pattern of patients with oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) with healthy controls. Material and Methods: The study included 90 subjects with 30 OPMDs, 30 OSCC and 30 healthy controls. Fasting blood samples were collected from subjects and were analysed for serum lipids, including the following: i) Total cholesterol (TC) ii) High-density lipoproteins (HDL) iii) Low-density lipoproteins (LDL) iv) Very low-density lipoproteins (VLDL) v) Triglycerides (TG) vi) CHO/HDL ratio by using semi auto analyser. Statistical Analysis Used: The statistical tests used were the independent t-test, ANOVA test. A P value of <0.05 and <0.01 was considered statistically significant. Results: A statistically significant decrease in serum TC, LDL and CHO/HDL ratio was observed among OPMD and OSCC groups than controls, whereas a significant decrease in serum VLDL and TG (p value <0.01) in poorly differentiated OSCC was seen. Conclusion: The study shows an association between lipid variations and OPMD and OSCC. Low levels of lipids could be due to the rapidly dividing cells in premalignancies and malignancies utilizing them for new membrane biogenesis. Thus, lower lipid status may be a useful indicator for initial changes happening in neoplastic cells.

Eosinophils: An imperative histopathological prognostic indicator for oral squamous cell carcinoma.

BACKGROUND: Inflammation in tumor microenvironment assists in both promotion and growth of tumor. Tumor-associated tissue eosinophilia (TATE) is the term used when eosinophils are observed in a tumor tissue with inflammatory infiltrate. Although carcinogenesis with inflammation is one of the important hallmarks, the exact role of eosinophils remains unclear. Various studies on oral squamous cell carcinoma (OSCC) that focused on eosinophils reported both favorable and unfavorable prognosis in cancer tissue, because of which the exact function of eosinophils still remains uncertain. AIMS AND OBJECTIVES: The present study aims at identifying the role of TATE in OSCC and in malignant transformation of oral epithelial dysplasia (OED). MATERIALS AND METHODS: The study includes 70 samples that divided into two groups, of which 50 histopathologically proven cases of different grades of OSCC and 20 cases of OED (oral leukoplakia). Congo red stain was used to stain the tissue sections. Each slide was viewed under high power in 10 consecutive microscopic fields for counting of eosinophils. RESULTS: Statistical analysis of values obtained was done using ANOVA, unpaired t-test and Mann-Whitney test. The results were statistically significant (P < 0.05) with a mean total eosinophil count of 2.12 in OED and 4.31 in OSCC. CONCLUSION: The present study showed higher eosinophil counts in OSCC when compared to dysplasia which should prompt for a thorough evaluation of tumor front for invasiveness. Therefore, tissue eosinophil count may be used as an adjunct to predict the malignant transformation of dysplastic lesions to OSCC.

Salivary Tumour Necrosis Factor-α as a Biomarker in Oral Leukoplakia and Oral Squamous Cell Carcinoma.

Background: Oral cancer is one of the life threatening disease which requires an availability of a biomarker for its early detection and also for effective treatment strategies. The current study is done to evaluate the efficacy of one such biomarker i.e. TNF- α as an indicator for oral precancer and oral cancer. Objectives: To evaluate the efficacy of Tumour necrosis factor - alpha (TNF)-α as a salivary biomarker in histopathologically diagnosed cases of oral leukoplakia and Oral squamous cell carcinoma. To correlate the levels of TNF- α with varying histologic grading in Oral Squamous Cell Carcinoma and dysplasia grading in Oral leukoplakia or Hyperkeratosis. Materials and Methods: The study group included 90 subjects that were divided into three groups. OSCC (n=30), leukoplakia (n=30) and controls (n=30). Cases were selected based on inclusion and exclusion criteria of the study. Salivary samples were then collected from all three groups. Salivary levels of TNF-α were estimated using Enzyme Linked Immunosorbent Assay (ELISA). The data on concentration gradients obtained were subjected to appropriate statistical analysis. Results: The results of the present study demonstrated higher levels of salivary TNF-α in individuals with OSCC compared to leukoplakia and healthy control subjects with a high level of statistical significance. ROC curve analysis along with diagnostic parameter calculation also revealed that salivary TNF-α to be a better medium for detecting OSCC. There is also an increase in the salivary TNF-α levels with increase in the histological grade of differentiation in OSCC as well as leukoplakia. Conclusion: The present study concludes that salivary TNF ­ α can be used as a prognostic biomarker of OSCC. In view of the elevated levels of TNF ­ α in saliva of individuals with severe dysplasia, it can also be used to monitor the malignant transformation to leukoplakia to OSCC.

Central mucoepidermoid carcinoma.

Central mucoepidermoid carcinomas (MECs) are extremely rare tumors, comprising 2-3% of all MECs reported in the literature. We report a rare case of clear cell variant of central MEC with calcifications occurring in the left posterior mandible in a 37-year-old male patient.

Mucoepidermoid Carcinoma of Floor of the Mouth - A Rarity.

Mucoepidermoid Carcinoma (MEC) is one of the most commonly occurring malignant salivary gland neoplasm, and contributes 2.8%-15% of all salivary gland tumours. More than half of these cases involve the major salivary glands, primarily the parotid glands and minor salivary glands. Sublingual salivary glands neoplasms are very rare and constitute 0.5% and 1% of all epithelial salivary tumours and approximately 1.5% of the major salivary glands carcinomas. Here we describe a case report of low grade mucoepidermoid carcinoma in the floor of the mouth in a 70-year-old female patient that was mimicking like a ranula clinically.

Oral mucosal lichen planus in nine-year-old child.

Lichen planus (LP) is a fairly distinctive mucocutaneous disease. The etiology of the condition appears to be complex and multifactorial, with unique histopathological features. Immunofluorescence studies have provided some insight into a proposed immunopathogenesis. LP is seen frequently in the middle-aged and elderly population. The female-to-male ratio is approximately 2:1. Children are rarely affected. The incidence of oral LP in children is reportedly high among Asians. We present a 9-year-old Indian child with the documented clinical aspects, histopathology and immunofluorescence studies.

Oral lichen planus. A review.

Lichen planus is a unique but common inflammatory disorder that affects the skin, mucous membranes, nails and hair. Oral lichen planus (OLP) is among the more common mucosal conditions a clinician is likely to encounter in his or her practice. The etiology is unknown. Immunofluorescence studies have provided some insight into a proposed immunopathogenesis. Buccal mucosa, tongue and gingiva are more commonly involved. The question of malignant transformation of OLP remains controversial. Management of lichen planus can be challenging and discouraging for both the patient and physician. Treatment options should be assessed for attendant risks and benefits, and tailored to the extent and severity of disease.

Assignment of the liposidomycin diazepanone stereochemistry.

The liposidomycins comprise a family of complex nucleoside antibiotics that inhibit bacterial peptidoglycan synthesis. Their structures (1, 2) feature nucleoside, ribofuranoside, diazepanone, and lipid regions. Several stereogenic centers remain unassigned, including three within the diazepanone region: C-6', C-2'", and C-3'". An intramolecular reductive amination reaction has been used to prepare model diazepanones. Analysis of 40 and two of its diastereomers by NMR spectroscopy, X-ray crystallography, and molecular modeling indicates a close relative configurational and conformational match between 40 and the liposidomycin diazepanone degradation product 43 and allows the assignment of stereochemistry of the natural products as either [C-6'(R), C-2'"(R), C-3'"(R)] or [C-6'(S), C-2'"(S), C-3'"(S)].