The role of interventional surgery in oral potentially malignant disorders

Oral potentially malignant disorders are mucosal diseases with a significantly increased risk of squamous carcinoma development – a lethal and deforming disease with rising incidence, especially in young people. Despite the ability to recognise pre-cancer disorders in patients, clinicians remain unable to predict individual mucosal lesion behaviour or quantify the risk of malignant transformation. No clear management guidelines exist and the available scientific literature is unable to answer the fundamental question: does early diagnosis and interventional management treat pre-cancer effectively and prevent malignant transformation?

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TNFα Signaling Is Increased in Progressing Oral Potentially Malignant Disorders and Regulates Malignant Transformation in an Oral Carcinogenesis Model

Frontiers in Oncology ◽

10.3389/fonc.2021.741013 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jeffrey W. Chadwick ◽

Rachel Macdonald ◽

Aiman A. Ali ◽

Michael Glogauer ◽

Marco A. Magalhaes

Keyword(s):

Malignant Transformation ◽

Oncologic Outcomes ◽

Oral Potentially Malignant Disorders ◽

Critical Pathways ◽

Oral Carcinogenesis ◽

Multi Stage ◽

Potentially Malignant Disorders ◽

Potentially Malignant

Oral carcinogenesis represents a multi-stage process which encompasses several genetic and molecular changes that promote the progression of oral potentially malignant disorders (OPMDs) to oral squamous cell carcinomas (OSCCs). A better understanding of critical pathways governing the progression of OMPDs to OSCCs is critical to improve oncologic outcomes in the future. Previous studies have identified an important role of tumor necrosis factor α (TNFα) and TNF receptor 1 (TNFR1) in the invasiveness of oral cancer cell lines. Here, we investigate the expression of TNFα and TNFR1 in human OPMDs that progress to OSCC compared to non-progressing OPMDs utilizing fluorescent immunohistochemistry (FIHC) to show increased TNFα/TNFR1 expression in progressing OPMDs. In order to interrogate the TNFα/TNFR1 signaling pathway, we utilized a 4-nitroquinoline 1-oxide (4-NQO) mouse model of oral carcinogenesis to demonstrate that TNFα/TNFR1 expression is upregulated in 4-NQO-induced OSCCs. TNFα neutralization decreased serum cytokines, inhibited the development of invasive lesions and reduced tumor-associated neutrophils in vivo. Combined, this data supports the role of TNFα in oral malignant transformation, suggesting that critical immunoregulatory events occur downstream of TNFR1 leading to malignant transformation. Our results advance the understanding of the mechanisms governing OSCC invasion and may serve as a basis for alternative diagnostic and therapeutic approaches to OPMDs and OSCC management.

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Genetic and Proteinic Linkage of MAO and COMT with Oral Potentially Malignant Disorders and Cancers of the Oral Cavity and Pharynx

Cancers ◽

10.3390/cancers13133268 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3268

Author(s):

Ping-Ho Chen ◽

Yen-Yun Wang ◽

Ting-Hsun Lan ◽

Leong-Perng Chan ◽

Shyng-Shiou Yuan

Keyword(s):

Oral Cavity ◽

Potential Role ◽

Nucleotide Polymorphisms ◽

Oral Potentially Malignant Disorders ◽

Clinical Biomarkers ◽

Group I ◽

Increased Risk ◽

Potentially Malignant Disorders ◽

Potentially Malignant

Betel quid (BQ), a group I human carcinogen, strongly contributes to an increased risk of oral potentially malignant disorders (OPMD) and cancers of the oral cavity and pharynx. This study was conducted to discover whether monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT) variants play a potential role in the risk assessment of oral cavity and pharynx cancers and OPMD, particularly among BQ users. We applied a case–control study to confirm the polymorphism of MAO and COMT using single-nucleotide polymorphisms. We used qRT-PCR, Western blotting, and immunohistochemistry (IHC) to determine MAO and COMT expression. Carriers of the MAOA rs6323 G-allele, MAOB rs6324 G-allele, and COMT rs4633 C/C-genotype had a prominently increased risk of oral cavity and pharynx cancers (AOR = 56.99; p < 0.001). Compared to adjacent noncancerous tissues, a significant downregulation of MAO and COMT expression was exhibited in cancerous tissues (p < 0.01). Furthermore, in different cell models, MAO and COMT expression was significantly downregulated with an increased dose of arecoline (p < 0.01). In personalized preventive medicine for oral and pharyngeal cancers, our findings are the first to demonstrate the potential role of lower MAO and COMT expression levels, with the risk polymorphisms utilized as clinical biomarkers.

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Managing oral potentially malignant disorders:A question of risk

Faculty Dental Journal ◽

10.1308/rcsfdj.2015.186 ◽

2015 ◽

Vol 6 (4) ◽

pp. 186-191 ◽

Cited By ~ 9

Author(s):

Peter Thomson

Keyword(s):

Clinical Practice ◽

Malignant Transformation ◽

Disease Process ◽

Squamous Carcinoma ◽

Oral Disease ◽

Increased Risk ◽

Potentially Malignant Disorders ◽

Potentially Malignant ◽

Malignant State

The concept of an oral disease process that presents as a ‘potentially malignant state’ that is neither entirely benign nor frankly malignant is a difficult concept both for clinicians and their affected patients. While it is recognised that a range of oral mucosal conditions, now collectively termed ‘potentially malignant disorders’, harbour an increased risk of squamous carcinoma, we remain frustratingly unable in contemporary clinical practice to predict individual lesion behaviour, quantify the risk of malignant transformation or objectively plan interventions.

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DNA Methylation Patterns in Saliva of Tobacco users with High-Risk Oral Potentially Malignant Disorders

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i32b31754 ◽

2021 ◽

pp. 129-137

Author(s):

Mimansha Patel ◽

Madhuri Nitin Gawande ◽

Minal Shashikant Chaudhary ◽

Alka Harish Hande

Keyword(s):

Dna Methylation ◽

High Risk ◽

Malignant Transformation ◽

Promoter Methylation ◽

Genomic Dna ◽

Premalignant Lesions ◽

Oral Potentially Malignant Disorders ◽

Potentially Malignant Disorders ◽

Potentially Malignant ◽

Methylation Patterns

Background: “Oral Potentially Malignant Disorder (OPMD)” is a well-known symptom that, if untreated, can be carcinogenic. It includes leukoplakia, erythroplakia or erythroleukoplakia. One of the typical premalignant lesions of the oral cavity is “oral leukoplakias (OLs),” which frequently precedes “OSCCs.”OLs with dysplastic characteristics are considered to be at a higher risk of “malignant transformation.” So, early diagnosis of "oral squamous cell carcinomas (OSCCs)" is desperately required to enhance patient prognosis and quality of life (QOL).As a result, we examined the distinctive promoter methylation presence in high-risk OLs. Objectives: To detect, compare & correlate “DNA methylation” patterns in normal individuals, tobacco users without disease and tobacco users with the disease. Methodology: With the participants' full consent, 48 saliva samples were obtained and prepared. DNA isolation, restriction digestion of genomic DNA, extraction of restriction enzyme digested genomic DNA, Polymerase Chain Reaction (PCR), and Agarose Gel Electrophoresis (AGE) were all carried out. Expected results: This study will help us to assess the use of Saliva as an aid to identifying both high and low risk “Oral Potentially Malignant Disorders.” Conclusion: Peculiar promoter methylation of various genes was related to a high possibility of malignant transformation in OLs.

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ORAL POTENTIALLY MALIGNANT DISORDERS ASSOCIATED WITH BETEL QUID CHEWING HABIT IN SAMOSIR ISLAND, NORTH SUMATRA INDONESIA

Dentika Dental Journal ◽

10.32734/dentika.v20i2.997 ◽

2017 ◽

Vol 20 (2) ◽

pp. 72-79

Author(s):

Indri Lubis ◽

Ameta Primasari ◽

Sayuti Hasibuan

Keyword(s):

Health Centre ◽

Betel Quid ◽

Control Group ◽

Oral Potentially Malignant Disorders ◽

Public Health Centre ◽

Increased Risk ◽

Betel Quid Chewing ◽

Potentially Malignant Disorders ◽

Potentially Malignant ◽

North Sumatra

Oral potentially malignant disorders have been associated with a betel quid chewing habit. To date, betel quid chewing has a major social and cultural role in the society of Samosir Island, North Sumatra, Indonesia. The purpose of the present study was to evaluate the occurrence of oral potentially malignant disorders associated with the habit of betel quid chewing in the society of Samosir Island, North Sumatra, Indonesia. This case-control study was conducted on all betel quid chewers in the working area of the Ambarita Public Health Centre in Samosir Regency, North Sumatra, Indonesia. All subjects were examined clinically for the presence of any oral lesions and interviewed for their betel quid chewing habit. Chi-square and Fisher’s exact tests were used to analyze the relationship between variables. Among the 51 subjects recruited in the study, 28 subjects suffered from oral potentially malignant disorders who had oral potentially malignant disorders such as submucous fibrosis and/or leukoplakia (the case group) whereas 23 subjects showed no clinically detectable oral potentially malignant disorders (the control group). An increased risk of oral potentially malignant disorders was associated with the habit of chewing areca nut and tobacco (OR=1.600; p=0.542), the duration of betel quid chewing more than 25 years (OR=4.379; p=0.023), and the frequency of betel quid chewing more than 6 times/day (OR=4.800; p=0.021). In conclusion, oral potentially malignant disorders were associated with chewing betel quid habit in the society of Samosir Island, North Sumatra, Indonesia.

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