Photodynamic therapy in the treatment of the right buccal mucosa verrucous carcinoma: a case report and literature review / 口腔疾病防治

Objective@#To explore the photodynamic treatment method and therapeutic effect of oral verrucous carcinoma and to provide a reference for the clinic.@*Methods@#This study follows the requirements of medical ethics. This paper summarized the photodynamic treatment of an oral verrucous carcinoma with a diameter of approximately 2.5 cm in the right buccal mucosa and retrospectively analyzed the characteristics and treatment of oral verrucous carcinoma and the photodynamic treatment of potential malignant lesions of the oral mucosa through a review of the literature.@*Results@#After four rounds of photodynamic therapy, the size of the right buccal lesion was significantly reduced. After 6 months of follow-up, the white verrucous hyperplasia of the right buccal mucosa had completely subsided, and there was no obvious scar formation. Three years after treatment, there was no recurrence of the lesion in the right buccal mucosa and no obvious scar formation in the treated area. The degree of mouth opening was 3 fingers, and there was no lymph node enlargement in the bilateral submandibular, submental or neck. The literature review shows that oral verrucous carcinoma is a rare subtype of squamous cell carcinoma with the characteristics and biological behaviors of slow growth, low malignancy, and rare metastasis. Surgery is the preferred treatment, but there are some limitations. Photodynamic therapy is a minimally invasive, repeatable treatment with mild adverse reactions. In recent years, photodynamic therapy has been gradually applied for the treatment of potential malignant disorders of the oral mucosa and early oral squamous cell carcinoma and has achieved positive results, but it has not been reported for the treatment of oral verrucous cancer@*Conclusion@#Photodynamic therapy is a new option for nonsurgical resection of oral verrucous carcinoma.

Co-expression of circRNA in oral leukoplakia and oral lichen planus / 口腔疾病防治

Objective@# To find any differentially expressed circRNAs in oral leukoplakia (OLK) and oral lichen planus (OLP), to investigate the possible role of circRNAs in the pathogenesis of these two diseases.@*Methods@# This study obtained hospital ethical approval. High-throughput sequencing was used to detect differentially expressed circRNAs in OLK, OLP, oral squamous cell carcinoma and normal oral mucosal tissues. CircRNAs were verified by qRT-PCR, enzyme tolerance assays and Sanger sequencing. GO functional analysis and KEGG pathway analysis were performed to predict the functions of circRNAs in OLP. TargetScan and miRanda were applied to predict targeted miRNAs and mRNAs of circRNAs, and ceRNA networks were mapped. @*Results@#A total of 49 circRNAs were differentially expressed in OLK and OLP together, including 30 upregulated and 19 downregulated circRNAs. The five circRNAs confirmed with RT-qPCR, including circHLA-C, circRNF13, circTTN, circSEPN2 and circALDH3A2, were all abnormally expressed in OLK and OLP, among which circHLA-C was a key circRNA with trans splice sites, which was validated by expanding the sample size. ROC curve analysis showed that the area under the circHLA-C curve for predicting OLK was 0.955, and the area under the circHLA-C curve for predicting OLP was 0.988. GO functional analysis showed enrichment of many biological processes related to the immune process. The KEGG pathway with the highest enrichment score was "Natural killer cell mediated cytotoxicity". HLA-C was significantly enriched in these processes/pathways. CeRNA network analysis showed that circHLA-C interacted with a variety of miRNAs, such as hsa-miR-26a-5p, hsa-miR-129-5p, and hsa-miR-29a-3p.@*Conclusion@#Many circRNAs were differentially expressed in both OLK and OLP, circHLA-C being the most elevated. CircHLA-C is valuable for the early diagnosis of OLK and OLP and may serve as a potential biomarker for the diagnosis and prognosis of OLK and OLP.

Diagnostic potential of Type VII Collagen during oral carcinogenesis

Abstract Type VII collagen (Col7) is a major component of anchoring fibrils. Col7 plays a role in tumor development and aggressiveness of cutaneous squamous cell carcinoma of recessive dystrophic epidermolysis bullosa. However, the role of Col7 in oral squamous cell carcinoma (OSCC) and oral leukoplakia (OL) remains largely unknown. Objective To elucidate the role of Col7 and its diagnostic potential during oral carcinogenesis. Methodology Col7 expression was immunohistochemically studied in 254 samples, including normal oral mucosa (NM), OL without dysplasia, OL with dysplasia, and OSCC. The correlation between Col7 expression and clinicopathologic parameters of OSCC was also determined. Results Col7 was present as a linear deposit at the basement membrane of NM, OL without dysplasia and OL with dysplasia, and at the tumor-stromal junction around tumor islands in OSCC. Discontinuity of expression was frequently observed in OL with dysplasia and OSCC. OSCC had the significantly lowest Col7 expression (p<0.0001). Compared with OL without dysplasia, OL with dysplasia showed significantly reduced Col7 expression. Patients in clinical stage 4 with positive nodes had low Col7 expression compared with those in clinical stage 1 and negative nodes, respectively. Conclusion Loss of Col7 is associated with tumorigenesis and aggressiveness in OSCC. A significantly reduced Col7 expression in OSCC implies that Col7 may be a useful marker for diagnosis and therapeutic targets.

Salivary Lactate Dehydrogenase and Salivary Alkaline Phosphatase as Salivary Biomarkers in Oral Potentially Malignant Disorders and Oral Squamous Cell Carcinoma - A Narrative Review

Background: Salivary lactate dehydrogenase (LDH) is catagorized in altered protein markers present in saliva which shows significantly increased level in oral carcinoma. On the other hand salivary alkaline phosphatase (ALP) is one of the sensitive markers for early detection of oral malignancy. As saliva sample collection is simpler, non-invasive and patient friendly, the use of salivary biomarkers for early detection of oral cancer has been increased remarkably in last decade. Aims & Objectives: To analyze the potential diagnostic role of major two biomarkers i.e, salivary LDH & salivary ALP in oral potentially malignant disorders & oral squamous cell carcinoma. Materials & Methods: In depth search of topic on major search engines like pubmed, google scholar, EBSCO, Wiley online pertaining to the enzymes like salivary LDH, salivary ALP with keywords like salivary LDH, salivary ALP, oral potentially malignant disorders, oral squamous cell carcinoma, salivary biomarkers were done. The literature review was done from 2010-2019. The available data is tabulated & presented under various topics of discussion regarding their regulation & functionality in the body harbouring those disorders & conditions. Conclusion: The salivary LDH is found to be more promising salivary biomarker for detection of oral cancer as per this study. Quite a number of studies have been done during the last decade on the same. Whereas, there is paucity of studies on the role of salivary ALP as a biomarker for oral cancer, instead we can say the role of salivary ALP is rather more in periodontitis in comparison to carcinoma.

Consensus guidelines on management of oral potentially malignant disorders

Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs) and early detection can downstage the disease. The majority of OPMDs are asymptomatic in early stages and can be detected on routine oral examination. Though only a proportion of OPMDs may transform to oral squamous cell carcinoma (OSCC), they may serve as a surrogate clinical lesion to identify individuals at risk of developing OSCC. Currently, there is a scarcity of scientific evidence on specific interventions and management of OPMDs and there is no consensus regarding their management. A consensus meeting with a panel of experts was convened to frame guidelines for clinical practices and recommendations for management strategies for OPMDs. A review of literature from medical databases was conducted to provide the best possible evidence and provide recommendations in management of OPMDs

Health-Related Quality of Life among Patients with Oral Potentially Malignant Disorder and Oral Cancer in Malaysia

ABSTRACT@#Presently there is a lack of health-related quality of life (HRQOL) measure and its corresponding utility values for oral cancer and oral potentially malignant disorders (OPMD). This limits patient-centered outcomes for cost-effectiveness evaluations. The study aimed to determine post-treatment HRQOL of patients and ascertained differences between OPMD, early and late-stage oral cancer. A cross-sectional survey was conducted among patients in oral maxillofacial specialist clinics in two public tertiary hospitals. Consented participants were required to complete the EQ-5D-5L questionnaire with the EQ Visual Analogue System (VAS). Kruskal-Wallis test was used to explore differences in values between stages. Multiple linear regression was used to explore factors that influenced the HRQOL. A total of 50 OPMD and 52 oral cancer patients were surveyed. The mean EQ-5D-5L health utility values was 0.842 (n = 50, SD = 0.139), 0.822 (n = 10, SD = 0.150) and 0.626 (n = 42, SD = 0.310) for OPMD, early- and late-stage cancer, respectively. The mean values of the EQ-5D-5L index and EQ-VAS scale showed significant differences between groups and between early- and late-stage cancer with good discriminative properties. Results of the multiple linear regression indicated that ethnicity, income, residency, diagnosis, and treatment modality were able to significantly account for 25% of EQ-5D-5L utility values, F(10,91) = 3.83, p < 0.001, R2 = 0.360. Indian ethnicity, rural location, income less than RM4,360, late-stage cancer, and multi-modal therapies were all predictors of poorer HRQOL. This study evidenced disease severity and treatment modality to greatly impact the HRQOL of patients, in addition to socio-demographic factors such as ethnicity and income.

Expression of Ki-67, Cyclin D1, P53, and P16 in patients with oral leukoplakia and leukoplakia cancerization with spicy diet in Chengdu / 华西口腔医学杂志

OBJECTIVES@#To investigate the expression of Ki-67, Cyclin D1, P53, and P16 in patients with oral leukoplakia (OLK) and OLK cancerization who have aspicy diet in Chengdu.@*METHODS@#Thirtypatients with OLK andspicy diet and 15 patients with OLK without spicy diet in Chengdu were divided into three groups: hyperplastic OLK (OLK-), OLK with mild to moderate dysplasia (OLK+), and severe dysplastic  OLK or oral squamous cell carcinoma (OSCC) transforming from OLK (OLK++/OSCC). The expression of Ki-67, Cyclin D1, P53, and P16 were detected by immunohistochemistry and statistically analyzed.@*RESULTS@#The expression of Ki-67 and P53 in patients with or without spicy diet in the OLK+and OLK++/OSCC groups were stronger than that of the OLK- group (@*CONCLUSIONS@#Spicy diet did not have an influence on the expression of Ki-67, Cyclin D1, P53, and P16 in patients with OLK and OSCC. The expression of Ki-67, Cyclin D1, and P53 increased with the development of OLK, whereas P16 showed opposite expression trend.

Etiology, pathogenesis, diagnosis and treatment of oral submucous fibrosis / 口腔疾病防治

@#Oral submucous fibrosis (OSF) is a chronic disease that produces scars, tissue fibrosis, and precancerous lesions. Epidemiological studies have shown that chewing betel nut is the most significant risk factor for OSF. Many studies have also indicated that habits such as chewing and smoking tobacco and drinking alcohol increase the risk of OSF, which is widely recognized as an oral precancerous lesion or a potentially malignant oral disorder. Pathological characteristics include chronic inflammation, excessive collagen deposition in the connective tissues below the oral mucous epithelium and local inflammation in the lamina propria or deep connective tissues. OSF patients have a 7%~30% chance of developing oral cancer. Submucosal local injection of triamcinolone and tanshinone was mainly used for the treatment of oral submucosal fibrosis. This treatment improves mouth opening and alleviates the burning sensation in OSF, and the treatment efficacy was as high as 93%. The article will discuss the occurrence, development, diagnosis and treatment of oral submucous fibrosis for clinical management by the medical community.

Randomized comparative study in the treatment of oral leucoplakia with laser and conventional surgery / Estudo comparativo randomizado no tratamento da leucoplasia oral com laser e cirurgia convencional

Objective: High-energy lasers are used as an alternative to surgical treatment of potentially malignant disorders in the oral cavity. The present article aims to make a prospective randomised comparative clinical assessment of the effect of laser surgery and conventional surgery in the treatment of oral leukoplakia (OL). Material and methods: In the study were included 89 patients with histologically confirmed oral leukoplakia lesions. Laser excision of the lesions using Er YAG laser was performed in 36 of the patients, while standard surgical excision was used in 53 of the cases. Following clinical assessment comparing the two treatment methods was conducted based on: pain, wound healing, infection and recurrence of the lesions. Results: A statistically significant difference between two groups according pain in the postoperative period was found. Patients treated with laser ablation experienced far less pain than those treated with surgical excision. The healing time was significantly faster in the group treated with Er YAG laser, and regarding the occurrence of postoperative infections, the results of the two methods did not differ significantly. Recurrence was observed earlier in the group treated with laser ablation, but the levels align over a longer period of time. Conclusion: Er YAG laser ablation is a contemporary method for the treatment of oral leukoplakia without dysplasia, providing similar success, compared to conventional surgical excision, with less postoperative discomfort for the patients. (AU)

Objetivo: Os lasers de alta potência são utilizados como alternativa ao tratamento cirúrgico de doenças potencialmente malignas da cavidade oral. O presente artigo tem como objetivo fazer uma avaliação clínica prospectiva e randomizada comparativa do efeito da cirurgia a laser e da cirurgia convencional no tratamento da leucoplasia oral (LO). Material e Métodos: No estudo foram incluídos 89 pacientes com lesões de leucoplasia oral confirmadas histologicamente. A excisão das lesões com laser Er YAG foi realizada em 36 dos pacientes, enquanto a excisão cirúrgica padrão foi utilizada em 53 dos casos. A avaliação clínica seguinte comparando os dois métodos de tratamento foi realizada com base em: dor, cicatrização da ferida, infecção e recorrência das lesões. Resultados: Foi encontrada diferença estatisticamente significante entre os dois grupos de acordo com a dor no pós-operatório. Os pacientes tratados com ablação a laser experimentaram muito menos dor do que aqueles tratados com excisão cirúrgica. O tempo de cicatrização foi significativamente mais rápido no grupo tratado com laser Er YAG e, em relação à ocorrência de infecções pós-operatórias, os resultados dos dois métodos não diferiram significativamente. A recorrência foi observada mais cedo no grupo tratado com ablação a laser, mas os níveis se alinham por um longo período de tempo. Conclusão: A ablação a laser Er YAG é um método contemporâneo para o tratamento da leucoplasia oral sem displasia, proporcionando sucesso semelhante ao da excisão cirúrgica convencional, com menor desconforto pós-operatório para os pacientes. (AU)

Salivary L-fucose as a biomarker for oral potentially malignant disorders and oral cancer

Background: The objective of this study was to evaluate the serum and salivary L-fucose in oral potentially malignant disorders (OPMDs) and oral cancer (OC) in order to investigate the possibility of using this as biomarker for early diagnosis. Materials and Methods: The study included 85 participants, who were grouped as control (30), OPMDs patients (25), and OC patients (30). Serum and unstimulated whole saliva were collected from participants of all groups and fucose estimation was done using spectrophotometry. The results were tabulated and analyzed statistically. Results: The mean serum L-fucose levels in normal, OPMDs, and OC group were 3.49, 19.18, and 35.75 mg/dl, respectively, while the levels of salivary L-fucose were 3.18, 7.02, and 11.66 mg/dl, respectively. A highly significant rise (P < 0.001) in serum and salivary L-fucose was observed in the study participants compared to control. Conclusions: The present study showed a significant and gradual increase in serum and salivary L-fucose from control to OPMDs to OC. From this study, we suggest that L-fucose can be used as a reliable biomarker and saliva can be used as a diagnostic fluid for screening and early detection of OC

Screening de lesiones orales malignas y potencialmente malignas en funcionarios de Universidad de Valparaíso y Universidad Viña del Mar durante los años 2016 - 2017 / Screening of malignant and potentially malignant oral lesions in employee of the University of Valparaíso and the University of Viña del Mar during 2016 - 2017

El objetivo de este estudio es determinar la prevalencia de lesiones orales malignas y potencialmente malignas (LPM) en funcionarios de la Universidad de Valparaíso y de Viña del Mar durante los años 2016 - 2017. Fueron citados 161 funcionarios, quienes accedieron a una encuesta que evaluaba factores de riesgo de cáncer oral (tabaco y alcohol) y si habían escuchado de la patología, sumado a un examen clínico. De los pacientes examinados, se diagnosticaron 121 lesiones de las cuales 2 fueron diagnosticadas como lesiones potencialmente malignas: Liquen plano y Leucoplasia, con una prevalencia de 1,7 %. El 50,3 % de los pacientes sabía de la existencia de cáncer oral. El Screening es una medida que permite dar a conocer a la población la existencia de cáncer oral y alertarlos sobre la importancia de su examen para su identificación de manera temprana.

The objective of this study is to determine the prevalence of malignant and potentially malignant oral lesions (PML) in University of Valparaíso and Viña del Mar employees, during the years 2016 - 2017. We cited 161 employees, who accessed a survey evaluating risk factors for oral cancer (tobacco and alcohol) and if they had heard of the disease. In addition, a clinical examination was carried out. Of the patients examined, 121 lesions were diagnosed, of which 2 were diagnosed as potentially malignant lesions: Lichen planus and Leukoplakia, with a prevalence of 1.6 %. 50.3 % of patients knew of the existence of oral cancer. Epidemiological designs are needed to better establish causality between risk factors and malignant or, potentially malignant lesions.

Serum Fucosylation Changes in Oral Cancer and Potentially Malignant Disorders

Background: Cellular glycosylation changes are associatedwith different types of neoplastic transformation. Fucose is adeoxyhexose sugar that the body requires for optimal functionsof cell to cell communications and which plays a role in severalbiological events. Fucose has been considered to play asignificant role in cancer and its spread. Alpha L Fucosidase(ALF) is an exoglycosidase involved in the hydrolyticdegradation of fucose containing components of glycoproteins,glycolipids and oligosaccharides. The significance of thisenzyme in human catabolism is implied by geneticneurovisceral storage disease. Altered levels of ALF has beenreported in the plasma/serum of patients with oral cancer.Aims: To investigate the clinical usefulness of serum fucoseand α-L-fucosidase in diagnosing oral pre-cancer and cancerand study the variations of the levels of both metabolites innormal, precancerous and cancerous conditions (Squamouscell carcinoma).Methodology: The study group comprised of 87 samples of(age range: 20-70 years): control samples – healthy individualswithout any systemic illness (n =20), clinically andhistopathologically diagnosed cases of leukoplakia (n=16) andoral submucous fibrosis (n=16) and oral squamous cellcarcinoma (n=35) respectively. 2ml blood was collected byvenipuncture from every subject after informed consent, serumwas separated and checked for fucose and fucosidase byspectrophotometric analysis.Results: The Normal value range of fucose is 8.3 to 9.5 mg/ dland that of fucosidase is 22.8 ± 7.1 U/L. There is an increasein the value range of fucose and fucosidase in the tissues ofpotentially malignant disorders and Squamous cell Carcinoma.

Research progress on the relationship between Candida albicans and oral potentially malignant disorders / 口腔疾病防治

@#Oral potentially malignant disorders (OPMDs) refer to all epithelial lesions and conditions with an increased risk for malignant transformation, including oral leukoplakia, oral submucous fibrosis, oral lichen planus, erythroplakia, etc. Additionaly, oral infection of Candida albicans is considered to be closely related to the development of OPMDs. It was demonstrated in previous studies that the detection rate of Candida albicans was higher in the oral mucosa with OPMDs; in addition, Candida albicans showed high virulence by adhering to and destroying the epithelium. Moreover, Candida albicans was able to induce the immune response and cause chronic inflammation in the epithelium, producing carcinogenic products such as acetaldehyde. The factors mentioned above play a key role in the occurrence and development of OPMDs. Furthermore, the oral mucosa is highly susceptible to Candida albicans. The present review provides an introduction to the relationship between Candida albicans and OPMDs.

Prevalence Of Oral Potentially Malignant Disorders In Realtion To The Use Of Chewable Tobacco

Introduction:Tobacco has been considered as a major etiological factor in the development of oral potentially malignant disorders. Any form of chewable tobacco is as significant in relation to oral carcinoma as is Smoked tobacco. Objective:To find out the association of Chewable tobacco with Oral Potentially Malignant Disorders.Material Methods: it was a cross sectional descriptive study through a self-structured questionnaire and oral examination by the observer in a sample of 1078 participants.Observations:Chewable tobacco increases 7.5 times more risk for having OPMD than non-chewers. Gutkha is the most common form of smokeless tobacco 115(55.8%) and supari 1(11.1%) is the least common form of smokeless tobacco present in the participants with. Strong association was seen between frequency of tobacco use and occurrence of oral precancerous lesions OPMD.Conclusions and Recommendations:The use of smokeless tobacco was significantly associated wit

Comparison of different stains in exfoliated oral mucosal cell micronucleus of potentially malignant disorders of oral cavity

Background: Micronucleus (MN) has been proved to be an important biomarker of genomic damage. Leishman Giemsa (LG) cocktail, being a relatively new staining technique, has not been used in exfoliative cytology. The aim of this study is to observe and compare the micronuclei (MN) frequency in potentially malignant disorders (PMDs) and also to compare the staining efficacy of May-Grünwald Giemsa (MGG), LG cocktail, and Papanicolaou (PAP) for micronuclei in exfoliated oral mucosal cells. Materials and Methods: Three smears were prepared from each 30 controls (buccal mucosa) and 120 patients (40 oral submucous fibrosis, 40 lichen planus, and 40 leukoplakia) clinically diagnosed with having one of the PMDs of the oral cavity stained with PAP, MGG, and LG cocktail stains. MN frequency (No. of MN/1000 cells) was evaluated and compared between the cases and the controls. Comparison between the three different stained smears was also made to determine the clarity and efficacy of the stains. Results: LG cocktail gave comparatively better results followed by PAP and MGG. Statistically significant results (P < 0.05) were obtained, using Mann–Whitney test for comparison of MN frequency between cases and controls. Conclusion: LG cocktail is an easy, cost- effective, and one step technique comparable to PAP staining; however, it warrants further study in its potential application in screening of oral cancer.

Evaluation of ABO blood groups in oral potentially malignant disorders and oral squamous cell carcinoma-a retrospective study in South Indian population

Context Oral squamous cell carcinoma (OSCC) has a multifactorial aetiology. Risk factors such as individual's lifestyle like chronic use of tobacco, spicy food, alcohol and smoking are associated with cancer. Recent studies have revealed the possibility of ABO blood group antigens role in development of cancer. Aims and objectives To detect and correlate ABO blood group type in oral potentially malignant disorders (OPMDs) and OSCC and to compare the ABO blood group type among controls, OPMDs and OSCC. Materials and methods Study included 100 subjects, 35 cases each of OPMDs and OSCC and 30 controls. ABO blood grouping was carried out by standard agglutination method (Spanclone ARKRAY Health Care Private Limited) based on the principle of haemagglutination reaction. Results We found that OPMDs and OSCC subjects to be more prevalent among cases with B blood group. There was a significant variation in age (P=0.004), sex (P=0.004) and blood group (P= 0.003) among controls, OPMDs and OSCC. Conclusion ABO blood grouping may be used as one of the diagnostic marker for OPMDs and OSCC.

Role of haematological parameters in oral potentially malignant disorders and oral squamous cell carcinoma-A comparative study

Context Oral squamous cell carcinoma (OSCC) is one of the most common cancers in human population and has a multifactorial aetiology. It is often preceded by oral potentially Malignant Disorders (OPMDs). Studies have shown that OSCC and OPMDs cause significant variations in various haematological parameters. Aim and objectives To assess the role of haematological parameters like haemoglobin, erythrocyte sedimentation rate, red blood cell count, white blood cell count and differential leukocyte count in OPMDs and OSCC and also to compare these parameters among OPMDs, OSCC and controls. Materials and methods Study comprises 30 diagnosed cases each of OPMDs and OSCC and 10 normal healthy age and sex-related individuals. Blood sample was collected from the patients and was evaluated for various haematological parameters by Sahli's acid haematin method, Westergren method and Coulter Counter ZF-6. Results There was a statistically significant difference in haemoglobin, red blood cell count, erythrocyte sedimentation rate, differential leukocyte count between OSCC, OPMDs and controls. Conclusion In the present study, haematological parameters were significantly altered in OPMDs and OSCC, and these variations may be useful in the prediction of malignant transformation and prognosis.

Revisiting the Efficacy of Immunomodulatory Effect of Hydroxychloroquine in Oral Lichen Planus: A Case Series

Oral lichen planus (OLP) is a common inflammatory, autoimmune disorder that affects stratified squamous epithelium. The exact etiopathogenesis of this mucocutaneous disease is still uncertain. Although OLP has been associated with altered Quality of Life and considerable morbidity, with important note for erosive type of OLP, its treatment is often disappointing and controversial. Though corticosteroids remained the first line of treatment for OLP, the associated adverse effects of corticosteroids are not acceptable. Hence, there is a need of drugs with steroid sparing effect. Use of immunomodulators is systemic pathologies is widely encountered. However, their use in oral lesions is not frequently seen. Use of hydroxychloroquine (HCQ), an age-old disease-modifyinganti-rheumatic-drug, has been widely used in various autoimmune diseases; however, it received little attention in treatment of OLP. This article presents a case series of three patients with erosive OLP which were managed with HCQ. The results presented allow the authors to consider systemic HCQ as a newer therapy for atrophicerosive lichen planus.

A Comparative Study of Micronuclei in Oral Exfoliated Epithelial Cells in Potentially Malignant and Oral Squamous Cell Carcinoma

Background Micronuclei are small, additional nuclei formed as a result of exclusion of chromosome fragments or the whole-chromosome lagging at mitosis. Micronuclei indirectly reflect the chromosomal breakage or impairment of mitotic apparatus. Micronuclei in exfoliated oral epithelial cells are widely used as biomarkers of chromosomal damage, genome instability and cancer risk in humans. Micronuclei scoring can be used as a biomarker to identify different preneoplastic conditions much earlier than manifestations of clinical features and might specifically be exploited in screening of high-risk population for a specific cancer. Aim To correlate frequency of micronuclei in oral exfoliated cells in clinically diagnosed cases of potentially malignant disorders (PMDs) and oral squamous cell carcinoma. Material and Methods The study subjects consisted of clinically and histopathologically diagnosed cases of oral squamous cell carcinoma, oral sub mucous fibrosis and leucoplakia. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmear from all the four groups were stained with Papanicolaou stain. Micronuclei were identified according to the criteria given by Tolbert et al. (1992). Result The frequency of micronuclei was higher in patients with oral squamous cell carcinoma as compared to the other subject groups and the difference was found to be highly significant. Conclusion This study concluded that there is gradual increase in micronuclei counts from normal oral mucosa to PMDs to oral carcinoma.

Oral lichen planus: clinical profile and determination of oral epithelial dysplasia / Liquen plano oral: perfil clínico y determinación de la displasia epitelial oral

Oral lichen planus (OLP) is the most common noninfectious oral disease and is considered a potentially malignant disorders (OPMDs). The etiology and pathogenesis of OLP are not completely understood and the malignant transformation remains under discussion. The aim was to asses the cytological and histological features of OLP, and establish relationship between clinical and microscopic profiles. A total of 10 patients diagnosed with OLP were investigated. Slides were prepared and stained with Hematoxylin­Eosin to identify 8 histological features and 8 cytological alterations. Finally, oral epithelial dysplasia degree was determined. Hyperplasia and loss of polarity of basal cells were detected in 90 % of cases. Anisonucleosis, nuclear pleomorphism and hyperchromasia affected 100 % of the sample. Six cases were classified as mild-grade OED, with no cases of severe-grade. Microscopic alterations were higher in women (P <0.0001) and moderate-grade OED was diagnosed only in this group (P <0.0014). The findings demonstrated that microscopic and clinical data association should be analyzed to a better understand of disease behavior. OED was absence only in one case, so the periodic follow-up of patients diagnosed with OLP is mandatory to avoid the malignant transformation.

El liquen plano oral (LPO) es la enfermedad no infecciosa más común y se considera un trastorno potencialmente maligno. La etiología y la patogénesis del LPO no se conoce y la transformación maligna sigue siendo objeto de debate. El objetivo de este estudio fue evaluar las características citológicas e histológicas del LPO y establecer la relación entre los perfiles clínicos y microscópicos. Un total de 10 pacientes diagnosticados con LPO fueron investigados. Secciones histológicas se prepararon y tiñeron con hematoxilina-eosina para identificar 8 características histológicas y 8 alteraciones citológicas. Finalmente, se determinó el grado de displasia epitelial. La hiperplasia y la pérdida de la polaridad de las células basales se detectaron en el 90 % de los casos. Anisonucleosis, pleomorfismo nuclear e hipercromasia afectaron al 100 % de las muestras. Seis casos fueron clasificados como displasia epitelial oral (DEO) de grado leve y no se reportaron casos de grado severo. Las alteraciones microscópicas fueron mayores en las mujeres (p <0,0001) y DEO de grado moderado fue diagnosticado sólo en este grupo (p <0,0014). Los resultados demostraron que la asociación de datos microscópicos y clínicos deben ser analizados para una mejor comprensión del comportamiento de la enfermedad. La DEO estuvo ausente sólo en un caso, por lo que el seguimiento periódico de los pacientes diagnosticados con LPO es necesario para evitar la transformación maligna.