Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India.

Background: There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion. Materials and methods: A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis. Results: Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study. Conclusion: Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Potential role of fibroblast senescence in malignant transformation of oral submucous fibrosis.

Oral Submucous Fibrosis (OSMF) is a disorder that occurs primarily due to the usage of betel nut and paan masala. The rate of malignant transformation from OSMF is 26 %. There are several markers to predict this malignant transformation such as inflammatory mediators, hypoxia, Cell cycle alteration, alteration in oncosuppressor genes, angiogenesis-related molecules, genetic susceptibility, and senescence. In carcinogenesis, multiple mutations occur leading to genetic damage. This affects the normal cell cycle and DNA repair. One of the reasons for the genetic damage and mutation to result is because of the release of by-products of oxidative metabolism called -reactive oxygen species (ROS) that can induce irreparable damage to cell structures. Free radicals produced in OSMF can cause DNA damage. An online search was performed on PubMed, Medline, Cochrane, and Web of Science databases. The keywords used were "oral Submucous fibrosis", "senescence-associated secretory phenotype molecule", "senescent fibroblast" and "oral squamous cell carcinoma". This review aims to narrate the role of senescence fibroblast cells in pathogenesis and malignant transformation of OSMF.