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.

Potency of Pfeiffer's Crystallization to Analyze Oral Leukoplakia and Squamous Cell Carcinoma.

OBJECTIVE: Oral cancer usually has an early precancerous stage before its actual malignant transformation. Although there are various approaches to diagnose early stages of cancer, yet there is one less explored, cost effective and simple technique known as crystallization test. The aim of the study was to reaffirm the effectiveness of Pfeiffer's crystallization test in screening oral leukoplakia and squamous cell carcinoma. METHODS: Fifty oral leukoplakia, sixty five oral squamous cell carcinoma and sixty healthy individuals participated in crystallization test. Single blood drop was used to perform the test and obtained crystal patterns were analysed. Cross tabulation and Chi-Square test was performed to find the frequency and association between the groups. Kruskal-Wallis H test and Mann Whitney U test was applied comparing mean transverse form. RESULTS: Sensitivity of crystallization test was 80% and 93.84% in oral leukoplakia and squamous cell carcinoma. Chi-Square analysis revealed highly significant transverse form between the study groups (p < 0.000). CONCLUSION: Crystallization test proves to be simple, reliable and minimal invasive diagnostic approach under strictly maintained physical conditions.

Significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia in oral precancer patients.

BACKGROUND/PURPOSE: Our previous studies found relatively higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with different types of oral mucosal diseases. This study evaluated whether patients with oral precancerous lesions (oral precancer patients) had significantly higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects. METHODS: The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects were measured and compared. RESULTS: We found significantly lower mean serum iron (for women only), vitamin B12, and folic acid levels and a significantly higher mean serum homocysteine level in oral precancer patients than in healthy control subjects (all P-values < 0.05). Moreover, 131 oral precancer patients had significantly higher frequencies of blood hemoglobin (3.1%), vitamin B12 (43.5%), and folic acid (46.6%) deficiencies and hyperhomocysteinemia (22.1%) than 131 healthy control subjects (all P-values < 0.05). Of 131 oral precancer patients, lower mean serum folic acid levels were found in 87 cigarette smokers than in 44 non-smokers (P = 0.002), in 26 smokers consuming > 20 cigarettes per day than in 61 smokers consuming ≤ 20 cigarettes per day (P = 0.024), and in 52 betel quid chewers than in 79 non-chewers (P = 0.051). CONCLUSION: There are significantly higher frequencies of anemia, serum vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in oral precancer patients than in healthy control subjects.

Gastric parietal cell and thyroid autoantibodies in oral precancer patients.

BACKGROUND/PURPOSE: Gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) may be present in oral mucosal disease patients. This study mainly assessed the frequencies of serum GPCA, TGA, and TMA positivities in 131 oral precancer patients. METHODS: Serum GPCA, TGA, and TMA levels were measured in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects. RESULTS: We found that 131 oral precancer patients had higher frequencies of serum GPCA (10.7% vs. 2.3%, P = 0.012, statistically significant), TGA (4.6% vs. 2.3%, P = 0.498), and TMA (8.4% vs. 2.3%, P = 0.054, marginal significance) positivities than 131 healthy control subjects. We also found that 1 (0.8%), 6 (4.6%), and 16 (12.2%) oral precancer patients had the presence of three (GPCA + TGA + TMA), two (GPCA + TGA, GPCA + TMA, or TGA + TMA), or one (GPCA only, TGA only, or TMA only) autoantibody in their sera, respectively. Of 10 TGA/TMA-positive oral precancer patients whose serum thyroid-stimulating hormone (TSH) levels were measured, 80%, 10%, and 10% of these 10 TGA/TMA-positive oral precancer patients had normal, lower, and higher serum TSH levels, respectively. We also found a significantly higher GPCA positive rate in 26 smokers consuming >20 cigarettes per day than in 61 smokers consuming ≤20 cigarettes per day (P = 0.008). CONCLUSION: Approximately 17.6% of 131 oral precancer patients have serum GPCA/TGA/TMA positivity. Only approximately 20% of TGA/TMA-positive oral precancer patients have either hypothyroidism or hyperthyroidism.

Circulating catecholamines are associated with biobehavioral factors and anxiety symptoms in head and neck cancer patients.

Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of "hand tremor" measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (ß = 157.5, p = .0377), while the "heart pounding/racing" symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (ß = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.

Determination and diagnostic value of CA9 mRNA in peripheral blood of patients with oral leukoplakia.

BACKGROUND: Oral leukoplakia is one of the most common oral premalignant disorder. The classical evaluation through tissue biopsy is not always valid to evaluate the risk of malignization. MATERIAL AND METHODS: RT-qPCR was performed on 47 blood samples (21 patients with leukoplakia, 2 with oral squamous cell carcinoma (OSCC), and 24 healthy patients) and on 11 tissue samples (3 leukoplakia, 4 OSCC, and 4 samples of healthy tissue). RESULTS: There are significant differences in expression between the different groups (F = 4.057, p = .006). The Duncan post hoc test shows that the only group that differentiates is the tumour tissue. Using Wilcoxon test, different covariables of patients with leukoplakia were analysed with respect to the group of healthy patients and no significant differences were observed. CONCLUSIONS: The diagnostic route through liquid biopsy has not been conclusive in this study, but there are significant differences in the levels analysed in the different tissue samples.

Serum metabolomics in oral leukoplakia and oral squamous cell carcinoma.

CONTEXT: Metabolomics is a core discipline of system biology focusing on the study of low molecular weight compounds in biological system. Analysis of human metabolome, which is composed of diverse group of metabolites, can aid in diagnosis and prognosis of oral squamous cell carcinoma (OSCC). AIM: The aim of the present study is to analyze and identify serum metabolites in oral leukoplakia and OSCC as a potential diagnostic biomarker and a predictor for malignant transformation of oral leukoplakia. SUBJECTS AND METHODS: Serum metabolomic profile of patients diagnosed with oral leukoplakia (n = 21) and OSCC (n = 22) was compared with normal controls (n = 18) using quadrupole time of flight-liquid chromatography-mass spectrometry. MassHunter profile software was used for metabolite identification, and statistical analysis to assess the variation of the metabolites was performed using Mass Profiler Professional software. Statistical significance between the three groups was expressed using ANOVA (P < 0.05), and intergroup comparison was done using Student's t-test (P < 0.05). RESULTS: Significant upregulation of estradiol-17-beta-3-sulfate, L-carnitine, 5-methylthioadenosine (MTA), 8-hydroxyadenine, 2-methylcitric acid, putrescine, and estrone-3-sulfate was seen in oral leukoplakia and OSCC than in normal controls. Furthermore, significant upregulation of 5,6-dihydrouridine, 4-hydroxypenbutolol glucuronide, 8-hydroxyadenine, and putrescine was evident in OSCC group than in oral leukoplakia. CONCLUSION: Upregulation of L-carnitine, lysine, 2-methylcitric acid, putrescine; 8-hydroxyadenine; 17-estradiol; 5,6-dihydrouridine; and MTA suggests their diagnostic potential in oral leukoplakia and OSCC. Further, a significant upregulation of putrescine, 8-hydroxyadenine, and 5,6-dihydrouridine in OSCC than in oral leukoplakia indicates their potential role in predicting the malignant transformation of oral leukoplakia.

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.

Plasma HPV DNA is detectable in oral leukoplakia patients.

BACKGROUND: Oral leukoplakia is considered a potentially malignant lesion for the development of squamous cell carcinoma, and various risk factors may be related to its development and malignant transformation, including the human papillomavirus (HPV). The aim of this case-control study was to detect the presence of HPV in fresh tissue, plasma and saliva samples obtained from patients with and without oral leukoplakia, and verify the correlation of the presence of DNA of HPV between different sources of materials. METHODS: In this study, 32 patients with oral leukoplakia and 24 patients selected in a case-control manner were included. DNA extraction from the samples was performed, and afterwards it was amplified by nested polymerase chain reaction (nPCR) for the detection of HPV (nPCR: MY09-MY11/GP05+-GP06+). RESULTS: The DNA of HPV was found in 68.75% of the fresh tissue samples; in 50% of plasma, and in 62.5% of saliva samples in the group of patients with leukoplakia; in comparison with 45.8%, 54%, and 45.8%, in the fresh tissue, plasma and saliva samples, respectively, in the control group. CONCLUSION: Based on the present study, there was no difference in the rate of HPV detection in patients with or without oral leukoplakia. However all sources tested in this study were considered suitable for HPV detection, especially plasma samples, which showed be an important non-invasive source of HPV detection in leukoplakia patients.

Evaluation of serum lipids and lipoproteins as prognosticators in leukoplakia.

BACKGROUND: Oral cancer is the 8th most common cancer worldwide. Squamous cell carcinomas constitute 94% of all oral malignancies and are often preceded by leukoplakia. Despite many adjunctive techniques to monitor transformation of leukoplakia to oral squamous cell carcinoma (OSCC), the mortality rate is on the rise. Incidentally, patients diagnosed with oral potentially malignant disorders (OPMDs) and oral cancers manifest with low choles-terol levels. Given a thought, hypolipidemia may be a useful adjunctive tool as it reflects the initial changes within the neo-plastic cells, thus giving a red alert in malignant transformation of leukoplakia at the earlier stage. AIM: To evaluate the feasibility of serum lipid profile as an adjunct early marker for malignant transformation of leukoplakia to OSCC. OBJECTIVES: To estimate the serum cholesterol, triglycerides and lipoprotein (HDL, LDL, VLDL) levels in patients with leukoplakia, OSCC and age matched healthy control group. To compare the serum cholesterol, triglycerides and lipoprotein levels between patients of leukoplakia, OSCC and age matched healthy control group. MATERIALS AND METHODS: The study group comprised of selected 30 individuals which included 10 each of histopathologically confirmed OSCC, leukoplakia and healthy controls. A written consent was taken from all of them, and a thorough case history was recorded and then venous blood was collected 12 hours post fasting and centrifuged. The serum cholesterol, triglycerides and HDL were estimated by enzymatic and colorimetric methods using commercially available kits--Roche/ Hitachi cobas systems. Chemistry assay QC procured from Bio-Rad was used as control. VLDL and LDL were derived from these values. Results were statistically analyzed using ANOVA and post hoc Tukey Test. RESULTS: Oral squamous cell carcinoma patients demonstrated significantly lower mean serum cholesterol level (151.60 mg/dl) than the control group (183.70 mg/dl). The mean cholesterol level in leukoplakia patients (173.90 mg/dl) was lower than that of control group (183.70 mg/dl) but higher than that of the OSCC group (151.60 mg/dl) with no statistical significance. CONCLUSION: Convenience, universal availability, patient compatibility and simplicity being the merits of serum lipid profile make it a feasible adjunctive prognosticator in leukoplakic patients.

Evaluation of salivary and serum lipid peroxidation, and glutathione in oral leukoplakia and oral squamous cell carcinoma.

Lipid peroxidation induced by reactive oxygen species (ROS) is involved in the pathogenesis of malignancy. Overall, lipid peroxidation levels are indicated by malondialdehyde (MDA), which is the most frequently used biomarker to detect oxidative changes. Antioxidant defense systems such as glutathione (GSH) limit cell injury induced by ROS. Therefore, MDA and GSH can be used to monitor oxidative stress (OS). Hence, this study aimed to evaluate and compare both salivary and serum levels of MDA and GSH in oral leukoplakia and oral squamous cell carcinoma (OSCC) patients, and healthy controls. The study included 100 subjects comprising 30 apparently healthy controls, 30 patients with oral leukoplakia and 40 clinically and histologically diagnosed patients with OSCC. Saliva and blood samples were obtained and evaluated for MDA and GSH. The study revealed enhanced MDA levels in saliva and serum in oral leukoplakia and OSCC patients as compared to controls. On the other hand, significant decreases were seen in serum and salivary GSH levels in oral leukoplakia and OSCC patients as compared to controls. Augmentation of OS in blood and saliva is reflected by increase in MDA and decrease in GSH levels, indicating that tumor processes cause an imbalance of oxidant-antioxidant status in cell structures.

Elevated level of serum growth differentiation factor 15 is associated with oral leukoplakia and oral squamous cell carcinoma.

BACKGROUND: Although molecular mechanism of growth differentiation factor 15 (GDF15) in tumorigenesis of oral squamous cell carcinoma (OSCC) is not clear, the diagnostic and prognostic value of serum GDF15 detection has been noticed. However, serum GDF15 levels in patients with oral leukoplakia and GDF15 as a potential predictive biomarker for response to induction chemotherapy in patients with OSCC have not been reported. METHODS: Pretreatment serum GDF15 concentration was detected using an enzyme-linked immunosorbent assay in 30 healthy persons, 24 patients with oral leukoplakia, and 60 patients with OSCC. RESULTS: Serum GDF15 concentration was significantly higher in patients with oral leukoplakia and OSCC, compared with healthy controls (F = 13.701, df = 2, P < 0.001). From a diagnostic standpoint, a cutoff value of 346.9 ng/l of serum GDF15 concentration was calculated using receiver operating characteristic curve, with a sensitivity of 0.750, specificity of 0.867, Youden's Index of 0.617, and area under curve of 0.863. From a prognostic standpoint, patients with serum GDF15 concentration <346.9 ng/l had an improved 3-year disease-free survival rate (64.3% vs 56.5%) compared with those above 346.9 ng/l, but the difference was not statistically significant. A decreased concentration of GDF15 (<346.9 ng/l) showed a predictive trend toward an improved response to induction chemotherapy compared with elevated concentration with clinical response rates of 100% and 71.4%, respectively, but the difference was not significant. CONCLUSION: Elevated GDF15 level may be not only a diagnostic biomarker for oral leukoplakia, but also a prognostic/predictive biomarker associated with decreased survival and diminished response to induction chemotherapy for patients with OSCC.

Serum total protein, albumin and advanced oxidation protein products (AOPP)--implications in oral squamous cell carcinoma.

BACKGROUND: The role of oxygen free radicals in the initiation, promotion and progression of carcinogenesis and the protective role of anti-oxidant defenses have been the subject of much speculation in the recent past with conflicting reports in the literature. OBJECTIVES: The aim of this study was to measure the concentration/levels of serum total proteins, albumin and advanced oxidation protein products as markers of oxidative stress in sera of patients with an oral pre-cancerous lesion and frank oral cancer. MATERIALS AND METHODS: The study consisted of sera analysis of 30 new patients of histologically proven well-differentiated, oral squamous cell carcinoma and 10 patients, clinically diagnosed with a potentially malignant epithelial lesion, speckled leukoplakia, aged between 40 to 60 years, in addition to 25 healthy controls. One way analyses of variance were used to test the difference between groups. The normality of data was checked before the statistical analysis was performed. RESULTS: The study revealed variations in sera levels of albumin and advanced oxidation protein products to be statistically significant (p<0.001). CONCLUSION: The results obtained emphasize the need for more studies with larger sample sizes to be conducted before a conclusive role could be drawn in favour of sera levels of total protein, albumin and advanced oxidation protein products as markers of diagnostic significance and of the transition from the various oral pre-cancerous lesions and conditions into frank oral cancers.

In search of malignant transformation: a pilot study.

CONTEXT: The role of oxygen free radicals in the initiation, promotion and progression of carcinogenesis and the protective role of antioxidant defenses has been the subject of much speculation in the recent past, with conflicting reports in the literature. AIMS: The aim of this study was to measure the concentration of serum total proteins and albumin and advanced oxidation protein products (AOPP) in the sera of patients diagnosed with speckled leukoplakia and well-differentiated oral squamous cell carcinoma. MATERIALS AND METHODS: The study consisted of sera analysis of 30 new cases of histologically proven well-differentiated, oral squamous cell carcinoma and 10 patients with speckled leukoplakia aged between 40 and 60 years in addition to 25 healthy controls. STATISTICAL ANALYSIS USED: One-way analysis of variance (ANOVA) was used to test the difference between groups. To find out which of the two groups' mean was significantly different, post hoc test of Scheffe was used. RESULTS: The study revealed variations in sera levels of albumin and advanced oxidation protein products to be statistically significant. CONCLUSIONS: The results obtained emphasize the need for more studies with larger sample sizes to be conducted before a conclusive role for sera levels of total protein, albumin and AOPP could be drawn as markers of transition of the various oral precancerous lesions and conditions to frank oral squamous cell carcinoma.

Salivary and serum interleukin 1 beta, interleukin 6 and tumor necrosis factor alpha in patients with leukoplakia and oral cancer.

OBJECTIVES: The aim of study was to compare salivary and serum concentrations of interleukin 1 beta (IL-1ß), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with oral leukoplakia, oral cancer and healthy controls. STUDY DESIGN: Eighty eight patients (28 with oral cancer, 29 leukoplakia, and 31 healthy controls) were included in this study. Cytokine concentrations were measured by commercial enzyme linked immunoassay. RESULTS: Salivary IL-1ß and IL-6 were significantly higher in oral cancer patients than in patients with leukoplakia and control group (p<0.05). No differences in concentrations of salivary TNF-α between either of the groups were observed. Serum concentrations of IL-1ß were below level of detection in all but two participants. No significant differences between the groups were observed in serum concentrations of IL-6. Serum TNF-α was significantly higher in control subjects than in oral cancer patients. CONCLUSIONS: Patients with oral cancer have elevated levels of inflammatory cytokines in their saliva. Whether this elevation can be used for monitoring the malignant transformation of oral leukoplakia remains to be answered by further follow up studies.

A new and preliminary three-dimensional perspective: proteomes of optimization between OSCC and OLK.

BACKGROUND: principally 80 percent of the malignant oral tumors are the Oral Squamous Cell Carcinoma (OSCC), which require quantities of such sacrifices as deformity, malfunction, recurrence, metastasis, deterioration, and mortality in common cases of failing to antedate diagnosis. Similarly critical is the Oral Leukoplakia (OLK) among precancerous lesions of oral mucosa. It would also be of interest for scholars and clinicians to target the discrimination as seizing up OLK intimate to OSCC. OBJECTIVE: through bioinformatics technology, the research in narration worked to establish a three-dimensional discriminate database from high throughput data of protein fingerprints from serum, saliva, and tissue samples of OSCC and OLK patients as a preliminary step towards integrated group proteins biomarker discovery and to further understanding of corresponding tumorgenesis and proteomics. METHODS: differential proteomic patterns in serum, saliva, and tissue between OSCC patients or OSCC tissues and OLK were detected by SELDI-TOF-MS technology, and discriminatively analyzed by ZUCI-PDAS (Zhejiang University Cancer Institute ProteinChip Data Analysis System) with Support Vector Machines (SVM) and cross validation. Additionally, Laser Capture Micro-dissection technology was utilized in the tissue research. RESULTS: mass/charge proteomes of optimization obtained from the samples were, respectively, 4162 with 6886 of 87.82%, 92.86%, 66.67% as the sensitivity, specificity, and accuracy for serum difference; m/z 5818, 4617 with 3884 of all 100% as the sensitivity, specificity, and accuracy for saliva difference; and m/z 3738, 11366 of 96.29%, 100.00%, 85.71% as the sensitivity, specificity, and accuracy for tissue difference between OSCC and OLK patients. CONCLUSIONS: within the fields of clinical biomarker application and bioinformatics utilization, as well as the exploitation and popularization of modern discriminate analysis technology, to determine preventative and therapeutic stage and prognosis of OSCC and OLK, the proteomes of optimization for discrepancy are suggested to be directly enrolled in clinical application without protein identification.

Correlation of serum biomarkers (TSA & LSA) and epithelial dysplasia in early diagnosis of oral precancer and oral cancer.

BACKGROUND: Oral cancer is currently the most frequent cause of cancer-related deaths, which is usually preceded by oral pre-cancerous lesions and conditions. Altered glycosylation of glycoconjugates, such as sialic acid, fucose, etc. are amongst the important molecular changes that accompany malignant transformation. The purpose of our study was to evaluate usefulness of serum Total Sialic Acid (TSA) and serum Lipid-Bound Sialic Acid (LSA) as markers of oral precancerous lesions and histopathologically correlating them with grades of epithelial dysplasia. METHODS: Blood samples were collected from 50 patients with oral precancer (Leukoplakia & OSMF), 25 patients with untreated oral cancer and 25 healthy subjects. Serum sialic acid (total and lipid bound) levels were measured spectrophotometrically. Tissue samples from all the patients were evaluated for dysplasia. RESULTS: Serum levels of total and lipid bound sialic acid were significantly elevated in patients with oral precancer and cancer when compared with healthy subjects. Analysis of variance test documented that there is progressive rise in serum levels of sialic acid with the degree of dysplastic changes in oral precancer patients. We observed positive correlation between serum levels of the markers and the extent of malignant disease (TNM Clinical staging) as well as histopathological grades. CONCLUSION: The results suggested that serum levels of TSA and LSA progressively increases with grades of dysplasia in precancerous groups and cancer group, when compared with healthy controls. These glycoconjugates, especially LSA has the clinical utility in indicating a premalignant change.

Possible action mechanism for curcumin in pre-cancerous lesions based on serum and salivary markers of oxidative stress.

Extensive research within the past half-century has indicated that curcumin (diferuloylmethane), a yellow pigment in curry powder, exhibits anti-oxidant, anti-inflammatory, and pro-apoptotic activities. We investigated whether the anti-pre-cancer activities assigned to curcumin are mediated through an anti-oxidant and DNA-protecting mechanism. Patients with oral leukoplakia, oral submucous fibrosis or lichen planus, and healthy individuals (n = 25 for each group) aged 17-50 years were selected. Salivary and serum oxidative markers such as malonaldehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), vitamins C and E were measured just prior to the intake of curcumin, after one week of curcumin intake and following clinical cure of precancerous lesions. Serum and salivary vitamins C and E showed increases, while MDA and 8-OHdG levels showed decreases in patients with oral leukoplakia, submucous fibrosis and lichen planus after intake of curcumin for all categories of precancerous lesions. The changes in these values were observed to be statistically significant after clinical cure of the disease (P < 0.05). The five-point rating scale for pain, as well as lesion size in oral leukoplakia, submucous fibrosis and lichen planus, improved significantly (P < 0.05). In addition, in submucous fibrosis, mouth opening (P < 0.05) recovered significantly. In oral leukoplakia, submucous fibrosis and lichen planus, the levels of serum and salivary vitamins C and E increased significantly, while MDA and 8-OHdG levels decreased after 131(15), 211(17), and 191(18) days, respectively. Values for serum and salivary vitamins C and E showed a significant decrease in oral leukoplakia, submucous fibrosis and lichen planus, in contrast to healthy individuals, but increased significantly in all groups subsequent to curcumin administration after clinical cure of lesions. Based on these results, we can conclude that curcumin mediates its anti-pre-cancer activities by increasing levels of vitamins C and E, and preventing lipid peroxidation and DNA damage.

Association between glycemia, serum lipoproteins, and the risk of oral leukoplakia: the population-based Study of Health in Pomerania (SHIP).

OBJECTIVE: Oral leukoplakia is an oral lesion with a premalignant character. Besides smoking and alcohol, diabetes could be a risk factor. The aim is to search for such an association. RESEARCH DESIGN AND METHODS: Subjects with leukoplakia (N = 123) from the population-based Study of Health in Pomerania (SHIP) were matched 1:2 for age and sex with unaffected control subjects. Behavioral and lifestyle factors were assessed by a questionnaire. Lipoprotein concentrations, glycemia, and inflammation parameters were determined. RESULTS Subjects with oral leukoplakia showed higher levels of diabetes-related metabolites, a higher LDL/HDL cholesterol ratio (P = 0.004), and higher A1C (P = 0.002), and they were more frequently smokers (P < 0.001). Assessed by conditional logistic regression, the probability of leukoplakia increases with current smoking (odds ratio 2.20 [95% CI 1.16-4.17]) and higher levels of A1C (1.51 [95% CI 1.08-2.12]), revealing interaction between both factors (P = 0.012). CONCLUSIONS: Diabetes is associated with the risk of oral leukoplakia, which is exaggerated by smoking. The risk is positively correlated with A1C concentrations.

Evaluation of correlation of serum lipid profile in patients with oral cancer and precancer and its association with tobacco abuse.

BACKGROUND: Cholesterol at either higher/lower level can be troublesome. Health issues related to higher than normal levels have received much public attention because of their relationship to incidence of heart disease, whereas implications of decreased cholesterol levels remain unclear. Present study tried to evaluate and correlate the decreased cholesterol levels in Oral cancer, Oral precancer and in tobacco abuse. METHODS: Total Cholesterol (TC), High Density Lipoproteins (HDL), Very Low Density Lipoproteins (VLDL), Low Density Lipoproteins (LDL) and Triglyceride (Tri) were estimated in 210 subjects. Out of these 210 subjects, 70 subjects were histopathologically confirmed Oral Cancer, 70 subjects were histopathologically confirmed Oral precancer (OPC) and 70, age and sex matched, healthy subjects who are not having Oral Cancer, Oral precancer and who had no history of any major illness in the past. These groups were subdivided into: Subjects with No Habit of Tobacco (NHT) and Subjects With Habit of Tobacco (WHT). RESULTS: There was significant decrease in TC, HDL, VLDL, and triglyceride in Oral Cancer group; and significant decrease in TC, and HDL in Oral precancer group as compared to Control. Mean serum lipid profile levels were not significantly different in subjects between NHT and WHT. CONCLUSIONS: There is an inverse relationship between serum lipid profile and Oral Cancer and Oral precancer. There was no overall significant correlation of serum lipid profile with tobacco abuse.