A comparative study of Candida species diversity among patients with oral squamous cell carcinoma and oral potentially malignant disorders

Abstract

Objectives To determine the prevalence of Candida species by PCR–RFLP method in the saliva of patients with oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMD) and healthy cohorts. Unstimulated saliva was collected from patients with OSCC (n = 97), OPMD (n = 200), and healthy controls (n = 200). Candida species were isolated using the standard protocol. The isolates were identified using phenotypic and genotypic methods. The odds/risk ratio was calculated using Pearson’s Chi-square test. The significance of Candidal carriage was calculated by independent T-test. Results Oral Candidal carriage was 72.2%, 58% and 20.5% among patients with OSCC, OPMD, and healthy controls respectively. The oral Candidal carriage in OSCC and OPMD was highly significant (p = 0.0001). Non albicans Candida predominated over Candida albicans. Candida species were diverse among the study groups with a predominance of Candida krusei, Candida tropicalis, and Pichia anomala formerly Candida pelliculosa. P. anomala occurrence outnumbered in health. The odds/risk ratio for OSCC and OPMD were 4.25/11.87 and 3.52/6.99 respectively. A high prevalence of non albicans Candida was observed both in all the three groups (OSCC, OPMD and healthy controls). High odds and risk ratio associates Candida species to OSCC and OPMD. Candida famata may be associated with OSCC and OPMD.

The Role of the Oral Microbiota in the Etiopathogenesis of Oral Squamous Cell Carcinoma

“…Candida spp. were associated with OSCC; increased relative abundances of this fungi were observed in saliva samples from patients with OSCC compared to those taken from healthy individuals and, similarly, in tumoral tissue compared to fibroepithelial polyps [ 82 , 83 ]. A microbial coexistence of C. albicans and a periodontal pathogen P. gingivalis has been described; these two microorganisms have a relationship in which C. albicans shields the P. gingivalis from recognition by the host immune system and, in this way, supports the bacterial infection [ 118 ].…”

“…For example, an increased incidence of the genera Candida , Hannaella , and Giberella was detected in samples of OSCC tumor tissues [ 82 ]. The mycobiota associated with OSCC is summarized in Table 2 [ 82 , 83 , 84 ].…”

Candida albicans Enhances the Progression of Oral Squamous Cell CarcinomaIn VitroandIn Vivo

“…OSCC is associated with the presence of oral candidiasis, but whether this is a cause rather than a causative relationship is unclear ( 15 , 17 – 19 , 46 – 48 ). We previously showed that the diversity of the oral fungal microflora of OSCC patients is remarkably different from that of healthy individuals, with significantly increased fungal burden and diversity in patients with oral tumors.…”

Candida albicansenhances the progression of oral squamous cell cancrinomain vitroandin vivo

“…OSCC is highly associated with the presence of oral candidiasis. However, the details of the cause versus causative relationship are not understood [25][26][27][28][29][30][31] . Our previous study showed that the diversity of the oral fungal microflora of OSCC patients is remarkably different from healthy individuals: the fungal burden and diversity of yeasts was significantly higher in patients with oral tumors compared to the oral cavity of healthy individuals.…”

“…Several other studies demonstrated a link between OSCC and Candida colonisation of the mouth 23,[28][29][30][31] . Candida infection in patients with cancer is usually considered to be the consequence of an altered immune status because both myelosuppression and mucositis enable the development of oral candidiasis 7,8,32,33 .…”