Clinical Review and Management of Oral Potentially Malignant Disorders with Epithelial Dysplasia

Normal Oral Mucosa ◽

Background: Oral potentially malignant disorders (OPMDs) comprise any disorders, tumors, in addition to any microscopic alterations that have a risk of malignant development of cancers of the mouth. When epithelial dysplasia is detected in an oral lesion, it is termed as a precancerous lesion. Finding: Several changes in the color or thickness of normal oral mucosa might be detected during the clinical diagnosis of the oral lesions. Leukoplakia of the oral cavity is a clinical name for one of the most predominant OPMDs of the oral mucosa. When comparing oral examination with naked eyes to planning to apply staining with special stain or using an image of optical fluorescence, the incidence of patients with oral epithelial dysplasia may rise, as well as the clearing of the lesion boundary. Increased size of more than 2cm2, the presence of colored regions with a red hue, the presence of lichenoid process characteristics, and severe epithelial dysplasia are all considered risk factors. One-third of premalignant lesions may progress to cancer, whereas the other two-thirds may stay stable or regress without progressing to malignancy. Conclusion: It is critical to research the patients' unique characteristics, which include psychological, genetic, dietary, and dental problems. When epithelial dysplasia is present in an oral lesion, it is termed a precancerous lesion. Oral potential malignant diseases with epithelial dysplasia may or may not develop into carcinoma and may or may not be recurrent.

Clinical Review and Management of Oral Potentially Malignant Disorders with Epithelial Dysplasia

Journal of Health and Medical Sciences ◽

10.31014/aior.1994.04.04.186 ◽

2021 ◽

Vol 4 (4) ◽

Author(s):

Mustafa Mohammed Abdulhussain ◽

◽

Ali Sami Muhsin

Keyword(s):

Oral Mucosa ◽

Precancerous Lesion ◽

Oral Lesion ◽

Epithelial Dysplasia ◽

Premalignant Lesions ◽

Normal Oral Mucosa ◽

Combination of Cytopathology and DNA Ploidy Increases the Performance of Oral Epithelial Dysplasia Prediction in Oral Potentially Malignant Disorders

Journal of Global Oncology ◽

10.1200/jgo.18.67600 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 69s-69s

Author(s):

Z.B.A. Karim ◽

T.G. Kallarakkal ◽

R. Amtha ◽

M.V. Guledgud ◽

A. Telang ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Dna Ploidy ◽

Epithelial Dysplasia ◽

Youden Index ◽

Potentially Malignant ◽

Oral Epithelial

Background: Grading of oral epithelial dysplasia (OED) by a pathologist is currently the key guide used for treatment planning of oral potentially malignant disorders (OPMDs). Conventional oral examination (COE) clinically detects OPMDs but may not predict their risk status to transform to cancer. Therefore, there is a need for a reliable test to predict OED in OPMDs. Aim: This study was conducted to evaluate COE, liquid based cytology (Cytopath) and DNA image cytometry (Ploidy) in predicting OED in OPMDs. Methods: A total of 179 patients from Malaysia, India and Indonesia underwent COE followed by brush biopsies and scalpel biopsies. Brush-biopsy samples were analyzed for cytopathology and DNA ploidy at Dental Faculty, University of Malaya. Histopathological findings of presence/absence of OED were used as the reference standard. Calculations for sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (A) were done for individual tools and in combinations. The Youden index (Sn+Sp-1) was used as a measure of overall performance. The relevant medical ethics committees of the different research locations approved the study. Results: For COE, the sensitivity (Sn) was high (100%) and the specificity (Sp) was low (5.9%), while both Cytopath and Ploidy showed a low sensitivity (Sn) (28.6% and 22.2%) and high specificity (Sp) (94.3% and 82.3%). All 3 tools individually have high negative predictive value (NPV) for predicting presence of OED (COE-100%, Cytopath-66.7%, Ploidy-78.5%). When combining outcomes from all 3 tools, the best performance indicated by Youden index (42.1) is which defines a positive case when both COE and Cytopath show abnormal. In general, using results from at least 2 tools had better Youden indices than using these tools individually. Conclusion: COE as a screening tool by virtue of its high Sn would be a suitable first level diagnostic test, while the Cytopath and the Ploidy individually with high Sp may be used as a second level test to predict presence of OED. Combining the COE with cytopathology would be the best combination for a high performance of the tools. Cytopathology (when performed by a trained cytologist) would allow for most of the false positives from the first level test to be correctly identified as true negative at the second level. Longitudinal data are needed to assess which of these may correctly identify the malignant potential of OPMDs. Acknowledgment: Grant: High Impact Research - Ministry of Higher Education (HIR-MOHE UM000025/C3)

Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2018.02.012 ◽

2018 ◽

Vol 125 (6) ◽

pp. 591-602 ◽

Cited By ~ 36

Author(s):

Susan Müller

Keyword(s):

Epithelial Dysplasia ◽

Potentially Malignant ◽

Oral Epithelial

Nuclear Blebbing Frequency in Tobacco-Induced Oral Potentially Malignant Disorders: A Pilot Study

Acta Cytologica ◽

10.1159/000516496 ◽

2021 ◽

pp. 1-8

Author(s):

Roopa Yadahalli ◽

Supriya Kheur ◽

Aanchal Adwani ◽

Ramesh Bhonde ◽

A. Thirumal Raj ◽

...

Keyword(s):

Oral Mucosa ◽

Tobacco Use ◽

Oral Submucous Fibrosis ◽

Oral Leukoplakia ◽

Clinical Staging ◽

Normal Oral Mucosa ◽

Significant Difference ◽

Introduction: Tobacco contains several genotoxic agents including N-nitrosamine which has the potential to cause significant nuclear damage. Nuclear blebbing is a form of protrusion on the nuclear membrane and could potentially be caused by tobacco-induced genotoxicity and is closely associated with malignancy. Thus, the present study aimed to assess if tobacco-associated oral potentially malignant disorders including oral submucous fibrosis (OSF) and oral leukoplakia have a higher nuclear blebbing frequency than patients with normal oral mucosa with no history of tobacco use. Methods: The sample consisted of patients with OSF (n = 30) and oral leukoplakia (n = 10) and normal oral mucosa (n = 10). Exfoliated cells collected from the study groups were smeared on a clean microscopic slide and stained by May-Grunwald-Giemsa stain. A baseline frequency of nuclear blebbing was evaluated using a bright-field microscope with a ×100 objective. The number of nuclear blebbing per 1,000 epithelial cells was recorded and expressed in percentage. ANOVA, the Mann-Whitney U test, and Spearman’s correlation were used to analyze the data. Results: The mean rank of distribution of nuclear blebbing showed significant difference between all 3 groups, with the highest frequency noted in leukoplakia, followed by oral submucous and normal oral mucosa. Within OSF, the frequency of nuclear blebbing significantly increased from early stage to advanced stage. In OSF, a statistically significant positive linear correlation was noted between duration (in years), frequency (per day) of tobacco use, clinical grading, and nuclear blebbing. Discussion/Conclusions: The frequency of nuclear blebbing was significantly higher in oral potentially malignant disorders than normal mucosa. Nuclear blebbing also exhibited a strong dose- and time-dependent correlation with tobacco usage and clinical staging in OSF. The nuclear blebbing frequency could be a noninvasive, economic tool to assess malignant risk in tobacco-induced oral potentially malignant disorders.

Expression of Interleukin-1ß and Interleukin-8 in Oral Potentially Malignant Disorders and Carcinomas

Frontiers in Oral Health ◽

10.3389/froh.2021.649406 ◽

2021 ◽

Vol 2 ◽

Author(s):

Jeaneth Lopez-Labady ◽

Ronell Bologna-Molina ◽

Mariana Villarroel-Dorrego

Keyword(s):

Oral Mucosa ◽

Study Groups ◽

Normal Mucosa ◽

Interleukin 8 ◽

Normal Oral Mucosa ◽

Potentially Malignant ◽

Oral Epithelial ◽

Oral Lichen

Objective: To evaluate interleukin-1ß (IL-1ß) and interleukin-8 (IL-8) epithelial expressions in potentially malignant disorders of the oral mucosa as malignant predictive markers.Study design: About 55 tissues embedded in paraffin, comprising 15 oral lichen planus (OLP) lesions, 15 leukoplakias, 15 oral squamous cell carcinomas (OSCC), and 10 samples of normal oral mucosa were included in the study. IL-1ß and 8 expressions were assessed by immunohistochemistry using antibodies antihuman IL-1ß human (sc-7884, Santa Cruz® H-153) and antihuman IL-8 (ab7747, abcam®). The number of positive cells was compared using Student's t-test. Any p-value < 0.05 was considered statistically significant.Results: Nuclear and cytoplasmatic keratinocyte staining were positive for both cytokines in all study groups. However, a statistically significant decrease was observed within all cases compared to normal mucosa, both staining for IL-1β and 8. Moreover, IL-8 showed significant differences between OLP and leukoplakia, and when compared to OSCC.Conclusions: Oral epithelial expression of IL-1β and 8 seems to decrease when the malignant transformation of the oral mucosa increases.

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 ◽

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.

APPLICABILITY OF ORAL EPITHELIAL DYSPLASIA GRADING IN POTENTIALLY MALIGNANT DISORDERS OF ORAL CAVITY-AN INSTITUTIONAL REVIEW

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2019.02.077 ◽

2019 ◽

Vol 128 (1) ◽

pp. e40

Author(s):

Dr. Karpagaselvi Sanjai ◽

Dr. Lalita Jayaram Thambiah

Keyword(s):

Oral Cavity ◽

Epithelial Dysplasia ◽

Institutional Review ◽

Potentially Malignant ◽

Oral Epithelial

Oral Potentially Malignant Disorders and Squamous Cell Carcinoma at the Tongue: Clinicopathological Analysis in a Thai Population

European Journal of Dentistry ◽

10.1055/s-0039-1698368 ◽

2019 ◽

Vol 13 (03) ◽

pp. 376-382 ◽

Cited By ~ 3

Author(s):

Anchisa Aittiwarapoj ◽

Rachai Juengsomjit ◽

Nakarin Kitkumthorn ◽

Puangwan Lapthanasupkul

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Epithelial Dysplasia ◽

Clinical Feature ◽

Male Predominance ◽

Dental Practitioners ◽

Abstract Objective Tongue is regarded as one of the common sites of oral squamous cell carcinoma (OSCC). This study aimed to determine the prevalence and clinicopathological profile of OSCC and oral potentially malignant disorders (OPMDs) at the tongue. Materials and Methods We retrospectively analyzed clinicopathological characteristics of 208 Thai patients diagnosed with SCC and OPMDs at the tongue in the period from 1996 to 2015. Chi-squared test was used to compare differences between patient’s clinical and histopathological features. Results Seventy-eight tongue SCC and 130 tongue OPMD cases were present over the study period. Slight male predominance was found for tongue SCC, while a slight female predominance was present for tongue OPMDs. Both tongue SCC and tongue OPMDs were mostly diagnosed in the old age patients (>40 years old). The majority of tongue SCC and OPMDs occurred at the tip and lateral of the tongue. The most common histologic grading of tongue SCC was well differentiated and no poor differentiation was found in this study. More than a half of tongue OPMDs showed epithelial dysplasia. Both tongue SCC and OPMDs demonstrated no significant correlation between clinical feature and histopathologic diagnosis. Conclusions Tongue SCC and OPMDs were particularly found in the elderly population and frequently developed at the tip and lateral of the tongue. Most of tongue OPMDs, particularly all of tongue erythroplakia, exhibited epithelial dysplasia. For dental practitioners, awareness in the early detection and diagnosis of these tongue lesions should be raised.