Association of podoplanin expression to histopathological grades of oral epithelial dysplasia and oral squamous cell carcinoma.

Objective: To determine the expression of podoplanin, and to correlate it with histopathological grades in oral epithelial dysplasia and oral squamous cell carcinoma cases. METHODS: The retrospective, analytical, cross-sectional study was conducted at the City Laboratory, Peshawar, Pakistan, and comprised specimen block data of histologically diagnosed cases of oral benign lesions, dysplastic lesions and oral squamous cell carcinoma from January 2017 to August 2021. Two sections (4um) were cut from each specimen block for Haematoxylin and Eosin staining and immunohistochemistry. The slides were re-evaluated by two pathologists for confirmation of the diagnosis, and podoplanin marker was applied to cases selected using immunohistochemistry. Data was analysed using SPSS 22. RESULTS: Of the 80 cases identified, 68(85%) were analysed. There were 20(29.4%) benign cases; 11(55%) females and 9(45%) males with mean age 39.90±16.23 years, 20(29.4%) oral dysplastic cases; 14(70%) males and 6(30%) females with mean age 57.75±12.02 years, and 28(41.2%) oral squamous cell carcinoma cases; 17(61%) males and 11(39%) females with mean age 50.55±14.80 years. Podoplanin expression in oral epithelial dysplasia cases was significant (p=0.028), while it was not significant in the other 2 groups (p>0.05). CONCLUSIONS: Podoplanin when used along with histopathological evaluation could aid as an adjuvant technique in the diagnosis and grading of oral epithelial dysplasia.

Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate.

OBJECTIVE: This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates. MATERIALS AND METHODS: This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs. RESULTS: The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs. CONCLUSIONS: Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.

Comparison of PD-L1 Expression in Oral Squamous Cell Carcinoma and Premalignant Lesions of Oral Cavity.

OBJECTIVE: Objectives of this study were to compare  expression of Programmed Death-Ligand 1(PD-L1) protein in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorder (OPMD) cases; and to compare the PD-L1 protein expression in histological grades of OSCC and also in OPMD's with Dysplasia and without Dysplasia. MATERIALS & METHODS: In this study,  25 cases of Oral squamous cell carcinoms, 25 cases of Oral Potentially Malignant Disorders and 10 cases of non-neoplastic oral mucosa (control) cases were included. FFPE blocks of OSCC and OPMD cases were contributed by Department of Pathology, Histopathology Division,Pakistan Institute of Medical Sciences, Islamabad. Immunohistochemical staining of cases with PD-L1 monoclonal antibody (1:100; Dako) was carried out at Histopathology division , PMC Labs,  Peshawar Medical College,Peshawar, Riphah International University, Islamabad . Epithelial cells (membranous and cytoplasmic) positivity was observed for PD-L1 Antibody. Data was analyzed in SPSS version20. For qualitative variables frequencies and percentages were calculated whereas for quantitative variables means and standard deviations were recorded. The Chi-square test was applied to evaluate the significant difference in categorical variables . p-value of ≤0.05 was taken as significant. RESULTS: PD-L1 expression in OSCC cases turned out to be 48% (n=12/25) as compared to 8% of OPMD cases (n=2/25) with a significant p value of 0.002 and all non-neoplastic oral mucosa cases were negative. PD-L1 expression in high grade OSCC cases was quite high (61% n=11/18) as compared to low grade OSCC (14% n=1/7) cases with a significant p value of 0.035. CONCLUSION: A statistically significant increased PD-L1 expression was noted in  OSCC as compared to OPMD. Expression of PD-L1 was more intense in high grade OSCC cases. The relation of PD-L1 expression to age ,gender or location of OSCC and OPMD cases , and presence of dysplasia in OPMD cases was statistically not significant.

Incidence of Dengue fever, serotypes, clinical features, and laboratory markers: a case study of 2019 outbreak at district Shangla, KP, Pakistan.

Background: Dengue is a widely spread mosquito-borne infection in humans, which in recent decades declared is public health problem globally. The dengue virus contains 4 different serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) which belong to the genus Flavivirus. Aims: A descriptive experimental study was conducted to determine the epidemiology, types of Dengue serotypes, clinical features, laboratory probe, and markers for primary diagnosis of dengue virus infection in hospitalized patients. Methodology: A total of 691 suspects were diagnosed from August to October 2019 in district Shangla KP, Pakistan. Serological tests were used for nonstructural protein-1 antigen (NS1), and antibodies (immunoglobulin-M (IgM) & Immunoglobulin-G (IgG)) while real-time PCR was used to confirm the cases. The data was statistically analyzed using IBM-SPSS Statistics 20 version. Results: The dengue virus infection was more prevalent in the male group (68.09%) than the female group (31.1%). A large number of patients were from rural areas (63.5%) while from urban areas were (36.4%), whereas Besham tehsil was found the most affected compared to other regions. The most prevalent serotype observed in our study was DENV-3 (56.60%) while DENV-4 was the least prevalent serotype (1.88%). Among the age-wise analysis of dengue-virus-infected individuals, the age group of 19-37 years (64.07%) was found the most affected group. The month-wise analysis revealed that the highest number of infections (49.8%) were recorded in September. Significant differences were noticed among blood parameters. Conclusion: The possible reasons for the dengue overwhelming in the study area could be less or lack of awareness particularly regarding the transmission of viral infections, improper sewage management, and no effective vector control strategies that lead the dengue outbreaks in the study population.

Serum p53 antibodies detection in oral squamous cell carcinoma, oral potentially malignant disorders and healthy individuals: A multicentre study.

OBJECTIVE: To detect antibodies against p53 in serum of patients of oral squamous cell carcinoma and oral potentially malignant disorders compared to healthy individuals. METHODS: The descriptive cross-sectional study was conducted at the departments of Oral and Maxillofacial Surgery, Peshawar Dental College, Peshawar, Khyber College of Dentistry, Peshawar, and the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from April, 2016 to March, 2017, and comprised serum of oral squamous cell carcinoma patients in group A, oral potentially malignant disorder patients in group B and healthy individuals in group C. Serum concentrations of anti-p53 antibodies were determined by enzyme-linked immunosorbent assay. Data was analysed using SPSS 20. RESULTS: Of the180 subjects, there were 60(33.3%) in each of the three groups. Circulating serum p53 antibodies were detected in 59(98.3%) cases in group A, 58(96.6%) in group B and in 20(33.3%) individuals in group C (p=0.001). CONCLUSIONS: The expression of circulating p53 antibodies in serum samples of squamous cell carcinoma and oral potentially malignant disorders patients indicates the potential to be a probable candidate for being taken as a diagnostic or prognostic biomarker.