DNA content abnormality in oral submucous fibrosis concomitant leukoplakia: A preliminary evaluation of the diagnostic and clinical implications

Abstract

Oral submucous fibrosis (OSF) is an insidious chronic oral and oropharyngeal potentially malignant disorder. Our previously studies reported that DNA image cytometry (ICM) using brushing added in the diagnosis of high-grade dysplasia and staging of oral leukoplakia (OLK). This preliminary study aimed to investigate the abnormal rate of DNA content in 30 cases of OSF including three cases of OSF concomitant OLK and evaluate their the diagnostic and clinical implications with special emphasis on the OSF concomitant OLK. Brushing and biopsy sample form each patient was processed by DNA-ICM and histological examination, respectively. The results of DNA-ICM analysis showed that all the lesions from the 27 patients with OSF only were identified as normal DNA content. Strikingly, two of three cases of OSF concomitant OLK were identified as abnormal DNA content, and one case of whom progressed to early oral squamous cell carcinoma at the follow-up of 31 months. Collectively, this preliminary evaluation revealed that DNA content abnormality was hardly observed in OSF only; however, it may be usually observed in OSF concomitant OLK, whom should be monitored on a priority basis for early detection of carcinoma. Multicenter large studies are needed to validate the findings of the current study.

DNA Image Cytometry for Screening the Carcinogenetic Risk of Oral Potential Malignant Disorders

“…OSF is a recognized OPMD with a high rate of progression to OSCC and OLK is the best known potentially malignant disease of oral cancer with a higher malignancy rate than OSF. It has been clinically observed that OSF may complicate OLK, and it was demonstrated that OLK could enhance the rate of malignant transformation from 7.2% of OSF only to 15.2% of it concomitant OLK, which is an important type of OPMDs 7 . Currently, dysplasia is recognized as a risk factor for assessing malignant transformation of OPMDs, but non-dysplastic OPMDs (ND-OPMDs) have also been found to develop oral cancer 28 .…”

“…Several articles have mentioned a phenomenon often observed in clinical settings, where OSF cases may be accompanied by OLK [6][7][8][9]. According to the reports, the incidence of OSF concomitant OLK (OSF+OLK) was 4.8%-24.5% in OSF cases.…”