Candida invasion and influences in smoking patients with multiple oral leucoplakias – a retrospective study

Abstract

Treating patients with multiple oral leucoplakias (MOLs) who smoke is more difficult and complicated than treating those with single oral leucoplakia (SOL). Removing the aetiological factors causing MOL can effectively prevent its recurrence. The aim was to study the infection by and influences of Candida in smoking patients with MOLs. A retrospective study was conducted on 136 smoking patients who had clinicopathological OLs. Among these patients, 73 lesions in 31 patients were MOLs, while 105 patients had SOLs. All patients were treated by complete resection. All specimens were tested for epithelial dysplasia, and stained with periodic acid-Schiff reagent. The rate of MOL concurrence with candidal infection was higher than that of SOLs. The incidence of Candida associated with MOLs was higher for recurrent than for non-recurrent lesions. The disease-free time was shorter in MOL patients with candidal infection. Moreover, MOLs with candidal infection were more likely to have an increasing ratio to combine with epithelial dysplasia. Candida is an important risk factor in smoking patients with MOLs. Microscopic and fungal examinations of those lesions should permit a detailed diagnosis in such patients and for long-term predictive assessments.

Oral leukoplakia manifests differently in smokers and non-smokers

“…Epithelial dysplasia, if present, exhibits different degrees of severity. 1,3,8,11 It has been shown that there are differences regarding clinical data when comparing dysplastic and non-dysplastic lesions, mainly in relation to gender, age, anatomical site, alcohol consumption and smoking habits. [11][12][13] Therefore, the aim of this retrospective study was to describe the clinical features observed in dysplastic and non-dysplastic OL lesions in both smokers and non-smokers.…”

“…2 The etiology of OL is variable, and tobacco has been considered a risk factor in a large number of cases, while alcohol, as an independent risk factor, is still questionable. [2][3][4][5][6][7] The concept of malignant transformation of OL is quite controversial. Studies have indicated that there is a 36% chance of malignant transformation if the lesion exhibits dysplastic features.…”

The Importance of a Proper Selection Area to be Biopsied in Nodular Leukoplakia: a Case Report

“…Besides, the presence of Candida and epithelial dysplasia is higher in multiple oral leukoplakia than in single oral leukoplakia (11). Some studies demonstrated that Candida invasion within the oral mucosa may induce an hyperplastic reaction that is a protective response of the host (12) and have an important association with moderate and severe epithelial dysplasia (13).…”

“…Prisutnost gljivice Candida potvrđena je mikrobiološkim metodama i histološkom analizom u većini slučajeva čvoraste leukoplakije (3,5,10), što pokazuje i naš slučaj -pronađena je opsežna kolonija tih gljivica na površini obložnog epitela i Munovi mikroapscesi. Prisutnosti gljivice Candida i epitelne displazije češća je kod multiple oralne leukoplakije negoli u slučaju pojedinačne (11). Neka istraživanja pokazala su da invazija gljivicama Candida kod oralne sluznice može potaknuti hiperplastičnu reakciju kao zaštitni odgovor domaćina (12) i usko je povezana s umjerenom i teš-kom epitelnom displazijom (13).…”

“…Neka istraživanja pokazala su da invazija gljivicama Candida kod oralne sluznice može potaknuti hiperplastičnu reakciju kao zaštitni odgovor domaćina (12) i usko je povezana s umjerenom i teš-kom epitelnom displazijom (13). Prema mišljenju Chia i suradnika (11), nitrosamini koje stvara soj gljivica Candida mogu sami ili zajedno s drugim kemijskim kancerogenima aktivirati specifične protoonkogene i tako potaknuti razvoj maligne lezije. Razmišljajući na taj način, gljivična superinfekcija može se smatrati značajnim rizičnim čimbenikom za onkogenezu (14).…”