Serum and salivary interleukin-1ß level in oral precancer: An observational study.

BACKGROUND AND AIM: Precancer biomarkers help in early detection and management of oral potentially malignant disorders (OPMDs). Interleukin-1ß (IL-1ß), a biomarker, is known to be altered in oral submucous fibrosis (OSMF) and oral leukoplakia (OL). Therefore, we evaluated and compared the serum and salivary IL-1ß levels in patients with OSMF/oral leukoplakia and in gender- and age-matched healthy individuals. MATERIALS AND METHODS: An in vivo, prospective, observational study was conducted on 40 subjects. Subjects were divided into two groups with 20 individuals in each group, that is, Group I: OSMF/oral leukoplakia and Group II: control group. Salivary and serum IL-1ß levels were quantitatively estimated using enzyme-linked immunosorbent assay (ELISA). The statistical tests used were unpaired t-test and Chi-square test. RESULTS: The serum IL-1ß levels were significantly (P 0.001) lesser in Group I in comparison to Group II. The salivary IL-1ß levels remained insignificant between both the groups. However, in both the groups, the salivary IL-1ß levels were significantly higher compared to the serum IL-1ß levels. CONCLUSION: We found that the serum IL-1ß level can be considered as a prospective biomarker for dysplasia, whereas salivary IL-1ß alone needs more elaborated studies to account for its application as a potential biomarker in OPMD.

Evaluation of Platelet Parameters in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma in a Background of Oral Submucous Fibrosis.

CONTEXT: The role of platelet parameters as markers of inflammation in various diseases is now in limelight. The interaction between cancer cells and platelets is a well-established phenomenon. Oral submucous fibrosis (OSMF) is a premalignant disorder with a malignant transformation rate of 2-8%. This study aimed to evaluate platelet parameters in OSMF and oral squamous cell carcinoma (OSCC) in the background of OSMF. This cross-sectional study was performed using secondary data retrieved between January 2019 and December 2019 in the Department of Oral Pathology and the Hematology Laboratory. METHODS AND MATERIALS: The data retrieved included 44 histopathologically proven OSCC in a background of OSMF (group III) and 36 OSMF (group II). The haematological parameters of these selected cases were retrieved from the Sysmex XN-1000 automated hematology analyser database. A control group (group I) comprises 50 subjects with normal (negative/unflagged) haematological parameters. All data were statistically analysed using SPSS 20.0. The significance level of tests was set at 5%. RESULTS: The mean platelet volume (MPV) (9.60 [±0.95] P < 0.001), platelet distribution width (PDW) (10.45 [±1.9], P < 0.001), platelet large cell ratio (PLCR) (21.70 [±7.98], P < 0.001), and the ratio of mean platelet volume to total platelet count (MPV/PLT) (0.03 [0.01], P < 0.001) were lower in group III when compared to the other two groups. CONCLUSIONS: Platelet parameters may be used as indices in the OSCC in the background of OSMF. However, large-scale prospective studies are necessary to evaluate the utility of these parameters during the malignant transformation of OSMF, thereby encouraging prompt treatment to prevent morbidity and mortality.

ABO Blood Groups and Its Association with Oral Cancer, Oral Potentially Malignant Disorders and Oral Submucous Fibrosis- A Systematic Review and Meta-Analysis.

OBJECTIVE: The study aimed to evaluate the association between ABO blood groups and oral cancer, other potentially malignant disorders (OPMD), and oral submucous fibrosis (OSMF). MATERIALS AND METHODS: A search was conducted in Medline, Cochrane databases, Google Scholar, Scopus, Web of Science and Directory of Open Access Journals (DOAJ) for studies evaluating ABO blood groups as risk factors for oral cancer and OPMD among cases and controls. The PRISMA guidelines were followed for the meta-analysis. Participants included patients with oral cancer, and OPMD diagnosed using histopathologic investigations.  Sub-group analysis was conducted to evaluate the association between blood groups and OSMF. Quality was evaluated using the Risk of Bias Assessment tool. Fixed effects model was used to assess the odds ratio for the association. RESULTS: There were 1352, 414, and 299 cases of oral cancer, OPMD, and OSMF and 11,699, 7382 and 7307 controls for analysis respectively. Blood group A was significantly associated with both oral cancer (Odds ratio: 1.27 [95% CI, 1.10, 1.47], P= 0.001) and OPMD (Odds ratio: 1.33 [95% CI, 1.01, 1.47], P= 0.04).  No association was noted between blood group B and AB with oral cancer, OPMD, and OSMF. Blood group O was significantly associated with lower chances of oral cancer (Odds ratio: 0.81 [95% CI, 0.71, 0.93], P= 0.002). CONCLUSION: Meta-analysis suggests blood group A has a greater risk for developing oral cancer and OPMD. Blood group O was associated with lower chances of oral cancer. No association was noted between ABO blood group system with OSMF.

Histo-Blood Group Antigens in Oral Cancer and Potentially Malignant Disorders.

BACKGROUND: Early detection of oral cancer is of critical importance because survival rates markedly improve when oral lesions are identified at an early stage. Aim of the present study is to investigate the expression of ABO (H) antigens in tissue specimens of oral cancer and potentially malignant disorders and to determine the role of ABO (H) antigens in tumour staging. MATERIALS AND METHODS: A prospective study was conducted on 60 cases of oral cancer and potentially malignant diseases. Specific red cell adherence test (SRCA-test) was used for studying A, B and O (H) antigens in tissue specimens and iso-antigenicity of epithelium was graded according to degree of adherence of indicator red blood cells. RESULTS: Among OSMF group, grade II adherence was seen in 53.3% cases, grade III in 33.3% cases, grade IV in 13.3% cases. In leukoplakia group, grade II adherence was seen in 26.7% cases, grade III adherence in 53.3% cases, grade IV adherence in 20% cases. Within the leukoplakia group, cases with dysplasia showed decreased adherence, compared with cases without dysplasia. Oral cancer group, negative adherence was seen in 13.3% cases, grade I adherence in 46.7% cases, grade II in 40% cases. In oral cancer group, antigen reactivity was less in poorly and moderately differentiated carcinoma, compared to well differentiated carcinoma. CONCLUSIONS: Antigen adherence and degree of loss of ABO (H) antigens in tissue specimens can be used for staging of the tumour.

Circulating MicroRNA-21 Expression as a Novel Serum Biomarker for Oral Sub-Mucous Fibrosis and Oral Squamous Cell Carcinoma

Background: Circulating miRNAs (miRs) in the biofluids such as serum and plasma act as potential biomarkers for early diagnosis, treatment and prognosis. In the present study, an attempt made to see the expression of miR-21 in serum of 20 cases of Oral sub-mucous fibrosis (OSMF), 20 cases of Oral squamous cell carcinoma and 40 healthy volunteers. The expression of miR-21 was evaluated in relation to different demographical and clinicopathological features such as sex, tobacco, pan-masala, alcohol, smoking and clinical staging respectively with an aim to identify correlation with oral pre-cancer and cancer stages. Materials and Methods: The relative expression level of miR-21 was determined by quantitative real-time RT-PCR (qRT-PCR) in the sera of 20 OSCC, 20 OSMF patients and 40 healthy subjects as a control. Association between expression of miR-21 and OSCC clinical stages and demographical parameters such as sex, pan-masala, tobacco, smoking, alcohol have also been analyzed in detail. Results: The results obtained by t-test revealed significant increase in the expression level of miR-21 in OSCC as compared to OSMF. The study also revealed the positive correlation between higher miR-21 expression and pan-masala chewers as shown by t-test. The statistical test, ANOVA has also indicated a positive correlation between up-regulation of miR-21 in the clinical stages of the OSCC. Conclusion: The results of present study indicated up-regulation of circulating miR-21 in serum of OSCC as compared to OSMF (p=0.001), this study also elucidated the positive correlation between miR-21 expression in OSCC/OSMF patients, only one demographical parameter (Pan-masala) and negative correlation for other parameters such as sex, tobacco, smoking, alcohol etc. Other findings suggested a significant increase (p=0.000) in the expression of miR-21 in clinical staging (I-IV) of oral cancer. More studies are needed to validate it as potential diagnostic and prognostic biomarker for OSMF and OSCC for better management.

Serum-based diagnostic prediction of oral submucous fibrosis using FTIR spectrometry.

Oral submucous fibrosis (OSF) is found to have the highest malignant potentiality among all other pre-cancerous lesions. However, its detection prior to tissue biopsy can be challenging in clinics. Moreover, biopsy examination is invasive and painful. Hence, there is an urgent need of new technology that facilitates accurate diagnostic prediction of OSF prior to biopsy. Here, we used FTIR spectroscopy coupled with chemometric techniques to distinguish the serum metabolic signatures of OSF patients (n=30) and healthy controls (n=30). Serum biochemical analyses have been performed to further support the FTIR findings. Absorbance intensities of 45 infrared wavenumbers differed significantly between OSF and normal serum FTIR spectra representing alterations in carbohydrates, proteins, lipids and nucleic acids. Nineteen prominent significant wavenumbers (P≤0.001) at 1020, 1025, 1035, 1039, 1045, 1078, 1055, 1100, 1117, 1122, 1151, 1169, 1243, 1313, 1398, 1453, 1544, 1650 and 1725cm-1 provided excellent segregation of OSF spectra from normal using multivariate statistical techniques. These findings provided essential information on the metabolic features of blood serum of OSF patients and established that FTIR spectroscopy coupled with chemometric analysis can be potentially useful in the rapid and accurate preoperative screening/diagnosis of OSF.

Determination of role of ceruloplasmin in oral potentially malignant disorders and oral malignancy-A cross-sectional study.

OBJECTIVES: In the process of carcinogenesis, lipid peroxidation and increased oxidative stress lead to changes in certain antioxidants. This study was aimed to assess and co-relate serum levels of ceruloplasmin in oral premalignancies and oral cancer so as to gauge its possible association with the process of carcinogenesis and to determine its role as tumor marker. MATERIAL AND METHODS: The study population comprised of 300 participants, equally divided into six study groups, that is, oral submucous fibrosis (OSMF), oral leukoplakia (OL), nicotina stomatitis (NS), oral malignancy (OM), controls (C), and healthy controls (HC); 5 ml of blood was collected from ante cubital vein from each participant. The serum was analyzed for ceruloplasmin levels using ERBA CHEM 5 PLUS semiautomated chemistry analyzer and diagnostic kit by turbidimetric immunoassay. RESULTS: There were total 242 males and 58 females, who were between 18 and 82 years of age, with a mean of 45.31 ± 13.97 years. The serum ceruloplasmin levels were significantly increased in OM, OSMF, OL, and NS groups as compared to C and HC groups (p < .001). No statistically significant difference was found in intragroup analysis of the disease groups (p > .05). CONCLUSION: Serum ceruloplasmin can be used as diagnostic marker for oral premalignant and malignant lesions.

Assessment of serum copper, iron and immune complexes in potentially malignant disorders and oral cancer.

Potentially malignant disorders (PMDs) of oral cavity and oral cancer remain a cause of serious concern despite intensive research and development. Diet and immunity have been identified to play a crucial role as modifying factors in these diseases. Our study intended to explore this relationship by estimating and comparing the serum levels of copper, iron and circulating immune complexes (CICs) in patients diagnosed with PMDs and oral cancer and normal healthy individuals. In this study, 40 histopathologically diagnosed cases of PMDs and oral cancer were included along with 30 healthy controls and 5 ml of venous blood was drawn using venipuncture. Serum estimation of copper, iron and CIC then followed using the colorimetric and spectrophotometric methods. The data obtained was subjected to statistical analysis using one way ANOVA and Pearson's Product-Moment Correlation Test. The mean serum copper level was measured as 138.98 ± 10.13µg/100ml in the PMD group and 141.99 ± 21.44 µg/100ml in the oral cancer as compared to 105.5 + 18.81µ/100ml in the controls. The mean serum CIC levels was highest in the oral cancer (9.65 ± 0.16OD470) followed by the PMD group (0.18 + 0.21 OD470) and least in the control group (0.048 ± 0.02OD470). Whereas, the serum levels of iron showed a significant decrease in the PMD group (110.9 ± 10.54 µg/100ml) and the oral cancer group (114.29 ± 25.83 µg/100ml) as compared with the control group (136.85 ± 14.48 µg/100ml). There was no positive correlation obtained between the three groups with respect to the chosen parameters indicating that the variables were independent of each other. It can be thus be ascertained that trace elements like copper and iron as well as humoral responses (CICs) have a close relationship with PMDs and oral cancers.

Is there an association between oral submucous fibrosis and ABO blood grouping?

BACKGROUND: Oral submucous fibrosis (OSMF) is one of the most common premalignant conditions in Indian subcontinent due to the traditional use of Areca nut and its various preparations. The genetic predisposition has also been reported in its etiopathogenesis. The rate of malignant transformation is between 7% to 14%. AIM: To evaluate whether ABO blood group is related to OSMF risk. SUBJECTS AND METHODS: It was a cross-sectional hospital-based study. A convenient sample of 164 study subjects constituted the cases and 180 subjects constituted the comparison group. STATISTICAL ANALYSIS USED: The results were analyzed using chi-square test and odds ratio. RESULTS: The chi-square analysis could not establish any significant relationship between OSMF and ABO blood group. But, when the strength of the association was measured using odds ratio, subjects with blood group A had 1.181 times higher risk of developing OSMF in comparison to other groups. CONCLUSION: The subjects with blood group A were at higher risk of developing OSMF in comparison to others. By performing blood group determination using a routine method at outreach programs, the susceptible individuals can be identified and counselled to quit the habit, thereby avoiding potential complications.

Estimation of serum malondialdehyde and assessment of DNA damage using comet assay in patients with oral submucous fibrosis.

AIM: To quantify the level of serum malondialdehyde and extent of DNA damage using comet assay in patients with oral submucous fibrosis (SMF) in comparison to normal individuals and to correlate the extent of DNA damage with MDA levels. METHODS: Study included 30 cases of SMF (n = 30) and equal number of healthy volunteers. Serum malondialdehyde was measured using the thiobarbituric-trichloroacetitic acid (TBA-TCA) method. Comet assay was used to assess the DNA damage. Association between the extent of DNA damage and serum MDA levels was analyzed in SMF statistically. RESULTS: Comet assay results showed that there was an increase in tail length, percentage of tail DNA and tail moment among SMF subjects (P < 0.05). Serum MDA levels were elevated in SMF patients compared with healthy subjects. A significant positive correlation was observed between serum MDA levels and comet tail length in SMF group (r = 0.56; P < 0.05). CONCLUSIONS: Patients with SMF have increased DNA damage and elevated levels of lipid peroxidation compared with healthy controls. Evaluation of MDA levels as an oxidative biomarker along with comet assay analysis will serve as a diagnostic tool to identify patients with high risk of malignant potential in SMF.

Assessment of serum copper, iron and immune complexes in potentially malignant disorders and oral cancer

Abstract Potentially malignant disorders (PMDs) of oral cavity and oral cancer remain a cause of serious concern despite intensive research and development. Diet and immunity have been identified to play a crucial role as modifying factors in these diseases. Our study intended to explore this relationship by estimating and comparing the serum levels of copper, iron and circulating immune complexes (CICs) in patients diagnosed with PMDs and oral cancer and normal healthy individuals. In this study, 40 histopathologically diagnosed cases of PMDs and oral cancer were included along with 30 healthy controls and 5 ml of venous blood was drawn using venipuncture. Serum estimation of copper, iron and CIC then followed using the colorimetric and spectrophotometric methods. The data obtained was subjected to statistical analysis using one way ANOVA and Pearson's Product-Moment Correlation Test. The mean serum copper level was measured as 138.98 ± 10.13µg/100ml in the PMD group and 141.99 ± 21.44 µg/100ml in the oral cancer as compared to 105.5 + 18.81µ/100ml in the controls. The mean serum CIC levels was highest in the oral cancer (9.65 ± 0.16OD470) followed by the PMD group (0.18 + 0.21 OD470) and least in the control group (0.048 ± 0.02OD470). Whereas, the serum levels of iron showed a significant decrease in the PMD group (110.9 ± 10.54 µg/100ml) and the oral cancer group (114.29 ± 25.83 µg/100ml) as compared with the control group (136.85 ± 14.48 µg/100ml). There was no positive correlation obtained between the three groups with respect to the chosen parameters indicating that the variables were independent of each other. It can be thus be ascertained that trace elements like copper and iron as well as humoral responses (CICs) have a close relationship with PMDs and oral cancers.

Exploratory Study to Evaluate Changes in Serum Lipid Levels as Early Diagnostic and/or Prognostic Indicators for Oral Submucous Fibrosis and Cancer among Gutkha Consumers in India.

BACKGROUND: In India smokeless tobacco users account for 25.9% of total tobacco use, Gutkha being the most common form. This study evaluated the association between serum lipid profile and Gutkha use as an early diagnostic and/or prognostic indicator for oral submucous fibrosis (OSMF) and oral cancer (Oral Ca) in non-smokers and non-alcohol consumers. MATERIALS AND METHODS: A total of 163 participants were recruited from two sites in India. Participants were divided into four groups: individuals without any Gutkha chewing habit and without any oral lesions (control group), individuals with Gutkha chewing habit but without any oral lesions (GWL), patients with a confirmed clinical diagnosis of OSMF, and patients with a confirmed diagnosis of Oral Ca. Mixed linear modelling (MLM) was conducted to detect the change in mean serum lipid levels among four groups. RESULTS: The sample consisted of 69% males and 31% females. Results of MLM show an inverse relationship between serum lipid levels in OSMF, and Oral Ca groups when compared to the control group. CONCLUSIONS: The results of our study demonstrated that GWL, OSMF and Oral Ca patients had lower serum lipid levels. Low serum lipid levels could be an indicator of initial neoplastic changes in oral cancer.

High frequencies of vitamin B12 and folic acid deficiencies and gastric parietal cell antibody positivity in oral submucous fibrosis patients.

BACKGROUND/PURPOSE: Oral submucous fibrosis (OSF) is a chronic progressive scaring oral disease associated with areca quid chewing. This study evaluated whether OSF patients had anemia, hematinic deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. METHODS: The blood hemoglobin (Hb), iron, vitamin B12, and folic acid concentrations, mean corpuscular volume, and serum GPCA in 68 male OSF patients were measured and compared with the corresponding data in 136 age-matched male healthy control individuals. RESULTS: We found that five (7.4%), 14 (20.6%), 34 (50.0%), 28 (41.2%), and nine (13.2%) of the 68 male OSF patients had Hb (< 13 g/dL), iron (≤ 70 µg/dL), vitamin B12 (≤ 450 pg/mL), and folic acid (≤ 6 ng/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, OSF patients had a significantly higher frequency of Hb (p = 0.006), vitamin B12 (p < 0.001), or folic acid (p < 0.001) deficiency and of serum GPCA positivity (p = 0.011) than healthy control participants. Of the five OSF patients with anemia, two had thalassemia trait, one had iron deficiency anemia, and two had macrocytic anemia (mean corpuscular volume ≥ 100 fL). In addition, of the nine OSF patients with serum GPCA positivity, six had vitamin B12 deficiency, five had folic acid deficiency, and two had iron deficiency. However, none of the nine GPCA-positive OSF patients had pernicious anemia based on the strict World Health Organization definition. CONCLUSION: We conclude that there are high frequencies of vitamin B12 and folic acid deficiencies and of serum GPCA positivity in our male OSF patients.

Evaluation of lactate dehydrogenase enzyme activity in saliva and serum of oral submucous fibrosis patients.

BACKGROUND: Of all oral precancerous conditions, Oral Submucous Fibrosis is of greater concern because of its disabling nature and relative greater chances of malignant transformation. This malignant transformation involves glycolytic pathways that can alter lactate dehydrogenase levels. Therefore the aim of this study was to estimate the LDH levels in saliva and serum of subjects with OSMF and to compare them with healthy controls and to correlate the relationship between pathogenesis of OSMF and the LDH enzyme. METHODS: Sixty Subjects were recruited for this study and divided into two groups, 30 subjects with OSMF (Group A) and 30 healthy controls (Group B). Venous blood and unstimulated whole saliva measuring 1 ml was collected from each of these evaluated for LDH levels using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software version 17. RESULTS: The average salivary LDH value for Group A was 606.83 ± 60.09 U/l and for Group B was 80.73 ± 20.06 U/l. salivary LDH was greater in group A than Group B and this was statistically significant. On comparing the serum and salivary LDH in Group A with the clinical staging of OSMF, the results were not statistically significant. Similarly no statistically significant relationship was found on comparing the serum and salivary LDH in Group A (OSMF subjects) with duration of habit. CONCLUSION: This study provides additional rationale for the role of salivary LDH in the early diagnosis and prognosis of oral submucous fibrosis.

Analysis of salivary secretor status in patients with oral submucous fibrosis: a case-control study.

AIM: Many individuals have various tobacco-related habits, yet only some develop clinical manifestation of lesions. This raises the question of whether there any inherent or host risk factors involved in the pathogenesis which need to be further investigated. The aim of the present study was to analyze the ABO antigen, secretor status, and blood groups of patients. METHODS: The study consisted of 99 participants, with 33 patients allocated to three groups: (a) patients with a tobacco-related habit and oral submucous fibrosis (OSF); (b) patients with a tobacco-related habit, but no lesions; and (c) healthy controls. A total of 1 mL unstimulated saliva was collected in a sterile test tube, and the Wiener agglutination test was performed to analyze the ABO antigen in all three groups. RESULTS: All of the OSF patients were non-secretors, whereas 84.8% were non-secretors in the group of individuals with habits as compared to 15.2% in the healthy group. A statistically-significant difference was observed between the OSF and healthy groups. The patients in the OSF group were predominantly blood-group A, followed by groups O, B, and AB. CONCLUSION: There is a correlation between salivary secretor status and the development of OSF. Thus, non-secretors are at greater risk of and more prone to the development of oral lesions. Blood-groups A and O predominate over the B and AB blood groups.

Estimation of serum superoxide dismutase and serum malondialdehyde in oral submucous fibrosis: a clinical and biochemical study.

BACKGROUND: To estimate the level of lipid peroxidation product (MDA) and the activities of antioxidative enzymes superoxide dismutase (SOD) and the correlation of these parameters in Oral Submucous fibrosis (OSF). AIMS: Estimation of MDA and SOD levels in OSF patients and controls. SETTINGS AND DESIGN: Patients above 15 years of age, who were diagnosed as OSF based upon thorough history, clinical examination and histopathological examination without any underlying systemic diseases, were included in the present study. Equal number of healthy subjects without any deleterious habits and without any clinically obvious oral lesions or systemic diseases were selected as the control group. MATERIALS AND METHODS: The estimation of MDA in serum was done by thiobarbituric acid reactive species method. SOD was assayed by inhibition and autoxidation of adrenaline method. STATISTICAL ANALYSIS USED: The data were analyzed with Student's t-test. RESULTS: Comparison of MDA, SOD among the OSF group and control group showed statistically significant increased levels of malondialdehyde and decreased levels of superoxide dismutase among the OSF groups. Significant changes were not seen in MDA and SOD levels between the different grades of OSF. CONCLUSIONS: From the present study, estimation of lipid peroxidation like MDA was done, which showed increased levels in the OSF group compared to the control group and antioxidant enzyme levels like SOD showed decreased levels in the OSF group compared to the control group. These can be considered as a subject of interest for their possible role in many of the precancerous and cancerous conditions.

Expression of tumor necrosis factor α and its correlation with severity of oral submucous fibrosis: a case-control study.

OBJECTIVE: The objective of this case-control study was to evaluate the plasma tumor necrosis factor α (TNF-α) levels in patients with oral submucous fibrosis and to determine the relation of plasma TNF-α levels with the severity of oral submucous fibrosis. STUDY DESIGN: Blood samples were collected from 25 patients who were diagnosed with oral submucous fibrosis and from 25 age- and sex-matched control participants. The plasma was isolated by centrifugation of blood samples. The levels of plasma TNF-α were estimated using enzyme-linked immunosorbent assay. RESULTS: A total of 19 out of 25 patients had detectable plasma TNF-α levels ranging from 0.1 to 106.4 pg/mL (mean, 23.46 pg/mL), whereas only 12 out of 25 control participants had detectable plasma TNF-α levels ranging from 0.1 to 33.3 pg/mL (mean, 6.93 pg/mL). The difference between the TNF-α levels of patients and controls was statistically significant (P = .015) according to the Mann-Whitney test. CONCLUSIONS: Patients with oral submucous fibrosis had significantly increased TNF-α levels compared with controls.

Trace elements (copper, zinc, selenium and molybdenum) as markers in oral sub mucous fibrosis and oral squamous cell carcinoma.

Oral cancer is a major cause of cancer morbidity and mortality worldwide and is prevalent in most areas where tobacco related practices are observed. Essential elements play a role in many biochemical reactions as a micro-source and there is growing evidence that their concentrations are altered on the onset and progress of malignant disease. In this study the levels of copper (Cu), zinc (Zn), selenium (Se) and molybdenum (Mo) in serum of patients with oral sub mucous fibrosis (OSMF) (n = 30) and oral squamous cell carcinoma (OSCC) (n = 30); were determined and the alterations of these critical parameters were analyzed in comparison with controls (n = 30) to identify predictors amongst these parameters for disease occurrence and progression. The serum Cu and Zn were established using Flame Atomic Absorption Spectrometry. Serum estimation of Se and Mo was done by graphite furnace atomic absorption spectrometry (GFAAS). Data analysis revealed a marked, progressive and significant increase in Cu levels in precancer (OSMF) and cancer (OSCC) groups as compared to the normal group. The level of Zn in serum was slightly elevated in OSMF and OSCC though not statistically significant. Cu/Zn ratio was slightly but not significantly elevated. Serum levels of Se and Mo were significantly decreased in the precancer and cancer groups as compared to the normals.

Can quantifying free-circulating DNA be a diagnostic and prognostic marker in oral epithelial dysplasia and oral squamous cell carcinoma?

PURPOSE: Previous studies have reported significantly higher concentrations of serum DNA in various types of cancers. Thus the study aims to determine whether circulating free DNA (CFDNA) can aid in the diagnosis and prognosis of oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: A nonrandomized case-control study was planned where cases were derived from patients who presented to the KLE Institute of Dental Sciences, Belgaum, India, for evaluation and management of oral lesions between 2007 and 2009. In this study the predictor variable was status of the disease in the patients, and the outcome variable was CFDNA. Demographic variables included age, gender, tobacco consumption, and stage at diagnosis of cancer. Subjects with any known systemic disease, other tumors, or metastatic OSCC were excluded (CFDNA is altered in cases of tissue destruction and inflammatory diseases). The amount of CFDNA was determined through spectrophotometry (NanoDrop ND-1000 spectrophotometer; Thermo Fisher Scientific, Waltham, MA) in sampled blood and plasma. Mean and range for DNA quantification in plasma and blood were calculated in all groups and compared by use of the analysis of variance test. RESULTS: A total of 390 cases (90 potentially malignant lesions, 150 OSCC cases, and 150 post-treatment OSCC cases) and 150 control subjects were studied. No significant difference was observed in levels of CFDNA in blood between the groups. Similarly, levels of CFDNA in plasma showed no significant difference except between the OSCC and potentially malignant groups, which was probably artifactual. CONCLUSIONS: This study shows that disease progression in oral malignancy does not correlate with changes in levels of CFDNA in blood or plasma.

Estimation of serum copper and zinc levels in oral submucous fibrosis: an atomic absorption spectroscopic study.

BACKGROUND AND OBJECTIVES: Biochemical derangements of microelements although reported in oral cancer is poorly understood in oral submucous fbrosis (OSMF). Hence, the present study was carried out to estimate and compare the serum copper and zinc levels among different histopathological stages of OSMF with that of healthy controls. MATERIALS AND METHODS: Thirty histopathologically diagnosed cases of OSMF and 30 healthy controls reporting to MS Ramaiah Dental College and Hospital (MSRDCH), Bengaluru, were included in the study. The histopathological staging of OSMF was done as per criteria given by Pindborg and Sirsat (1966). Blood samples were collected and the serum copper and zinc levels were estimated using atomic absorption spectroscopy. The results were statistically analyzed using independent t-test and Kruskal-Wallis test. RESULTS: The mean serum copper levels were increased (p < 0.0005) and zinc levels were decreased (p < 0.01) in OSMF patients when compared to that of controls. The mean serum copper levels showed an increasing trend from stage I to IV (p = 0.004) while zinc levels showed a decreasing trend from stage I to IV (p = 0.04) in OSMF patients. CONCLUSION: The serum copper and zinc levels in OSMF showed a signifcant difference in comparison to that of controls and between the histopathological stages. These fndings indicate that serum copper and zinc may have a contributory role in the etiopathogenesis of OSMF. CLINICAL RELEVANCE: Although the role of the trace elements as etiological factors is minor, derangements noted in the serum copper and zinc levels could be correlated with diseased progression and possibly explain the transformation of OSMF into malignancy. Thus, they can be used as prognostic markers and can be of value for proactive intervention.