Clinicopathological Correlation in Dysplastic and Malignant Lesions of The Oral Cavity and Oropharynx in Tertiary Care Center in Central India
Keywords:
Oral Squamous cell carcinoma, Oropharyngeal Squamous cell carcinoma, Dysplasia, Tobacco chewing
Abstract
Background: Late detection and diagnosis of oral and oropharyngeal carcinomas are responsible for the related increased morbidity and mortality. Understanding the risk factors and patterns of malignancy can help early identification and prompt treatment of patients with oral cancers. In the current study, we aimed to study the pattern of oral dysplastic and neoplastic lesions in tertiary care centre in central India and study its association with various risk factors. Methods: The oral biopsy tissues received in the Department of Pathology, GMC, Bhopal for histopathological evaluation during the duration of one and a half years were included in the study. The data was analysed by appropriate statistical tests (software SPSS). Result: A total of 334 cases presented for oral neoplastic lesions during the study period with mean age of presentation of malignant lesions and premalignant lesions being 51 years and 46 years respectively. 78.3% cases were reported as malignant lesions with majority being Well Differentiated Squamous Cell carcinomas (57%) among oral cavity lesions and Moderately Differentiated Squamous Cell Carcinoma (41%) among oropharyngeal lesions. 87% of patients reported use of tobacco chewing smoking and alcohol, either alone or in combination. Conclusion: High risk individuals included males more than 35 years of age indulging in tobacco chewing, smoking and alcohol with exclusive tobacco chewing associated more with oral malignant lesions whereas the smoking and alcohol along with tobacco chewing associated more with oropharyngeal lesions. Substance abuse awareness programs and screening early lesions in high risk individuals are recommended to curtail oral malignancies.References
1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015 Mar 1;136(5):E359-386.
2. Sharma S, Satyanarayana L, Asthana S, Shivalingesh K, Goutham BS, Ramachandra S. Oral cancer statistics in India on the basis of first report of 29 population-based cancer registries. J Oral Maxillofac Pathol [Internet]. 2018 ;22(1):18–26.
3. Rosai, J., Ackerman, L. V., & Rosai, J. Rosai and Ackerman’s Surgical Pathology -. In: Rosai and Ackerman’s Surgical Pathology [Internet]. 11th ed. Edinburgh: Mosby; 2011.
4. Lin W-J, Jiang R-S, Wu S-H, Chen F-J, Liu S-A. Smoking, alcohol, and betel quid and oral cancer: a prospective cohort study. J Oncol. 2011;2011:525976.
5. Jornet PL, Garcia FJG, Berdugo ML, Perez FP, Lopez AP-F. Mouth self-examination in a population at risk of oral cancer. Aust Dent J. 2015 Mar;60(1):59–64.
6. Kim S, Christopher L, John B. The Hematoxylins and eosin & Immunohistochemical techniques. In: Bancroft’s Theory and Practice of Histological Techniques [Internet]. 7th Edition. Churchill Livingstone; 2012.
7. Shenoi R, Devrukhkar V, Chaudhuri, Sharma BK, Sapre SB, Chikhale A. Demographic and clinical profile of oral squamous cell carcinoma patients: a retrospective study. Indian J Cancer. 2012 Mar;49(1):21–6.
8. Takeda T, Sugihara K, Hirayama Y, Hirano M, Tanuma J-I, Semba I. Immunohistological evaluation of Ki-67, p63, CK19 and p53 expression in oral epithelial dysplasias. J Oral Pathol Med. 2006 Jul;35(6):369–75.
9. Elango JK, Gangadharan P, Sumithra S, Kuriakose MA. Trends of head and neck cancers in urban and rural India. Asian Pac J Cancer Prev. 2006 Mar;7(1):108–12.
10. Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people--a comprehensive literature review. Oral Oncol. 2001 Jul;37(5):401–18.
11. Clinicopathological analysis of oral squamous cell carcinoma among the younger age group in coastal Karnataka, India: A retrospective study Abdulla R, Adyanthaya S, Kini P, Mohanty V, D’Souza N, Subbannayya Y - J Oral Maxillofac Pathol
12. Angiero F, Berenzi A, Benetti A, Rossi E, Del Sordo R, Sidoni A, et al. Expression of p16, p53 and Ki-67 proteins in the progression of epithelial dysplasia of the oral cavity. Anticancer Res. 2008 Oct;28(5A):2535–9.
13. AK E-N, JKC C, JR G, T T, PJ S. WHO Classification of Head and Neck Tumours. 4th ed. Vol. 9. IARC Publications; 2015 .
14. Tricker AR, Preussmann R. The occurrence of N-nitrosocompounds [corrected] in zarda tobacco. Cancer Lett. 1988 Oct;42(1–2):113–8.
15. Nair J, Ohshima H, Friesen M, Croisy A, Bhide SV, Bartsch H. Tobacco-specific and betel nut-specific N-nitroso compounds: occurrence in saliva and urine of betel quid chewers and formation in vitro by nitrosation of betel quid. Carcinogenesis. 1985 Feb;6(2):295–303.
16. Nair UJ, Floyd RA, Nair J, Bussachini V, Friesen M, Bartsch H. Formation of reactive oxygen species and of 8-hydroxydeoxyguanosine in DNA in vitro with betel quid ingredients. Chem Biol Interact. 1987;63(2):157–69.
17. Boffetta P, Mashberg A, Winkelmann R, Garfinkel L. Carcinogenic effect of tobacco smoking and alcohol drinking on anatomic sites of the oral cavity and oropharynx. International Journal of Cancer. 1992 Oct 21;52(4):530–3.
18. Blot WJ, McLaughlin JK, Winn DM. Smoking and Drinking in Relation to Oral and Pharyngeal Cancer. 1988;7.
19. Wynder EL, Stellman SD. Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977 Dec;37(12):4608–22.
20. Choi SY, Kahyo H. Effect of cigarette smoking and alcohol consumption in the aetiology of cancer of the oral cavity, pharynx and larynx. Int J Epidemiol. 1991 Dec;20(4):878–85.
21. Znaor A, Brennan P, Gajalakshmi V, Mathew A, Shanta V, Varghese C, et al. Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal cancers in Indian men. Int J Cancer. 2003 Jul 10;105(5):681–6.
22. Wey PD, Lotz MJ, Triedman LJ. Oral cancer in women nonusers of tobacco and alcohol. Cancer. 1987 Oct 1;60(7):1644–50.
23. Kruse AL, Bredell M, Grätz KW. Oral squamous cell carcinoma in non-smoking and non-drinking patients. Head Neck Oncol. 2010 Oct 4;2:24.
24. Cheng YW, Chiou HL, Sheu GT, Hsieh LL, Chen JT, Chen CY, et al. The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women. Cancer Res. 2001 Apr 1;61(7):2799–803.
25. Gealy R, Zhang L, Siegfried JM, Luketich JD, Keohavong P. Comparison of mutations in the p53 and K-ras genes in lung carcinomas from smoking and nonsmoking women. Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 1):297–302.
2. Sharma S, Satyanarayana L, Asthana S, Shivalingesh K, Goutham BS, Ramachandra S. Oral cancer statistics in India on the basis of first report of 29 population-based cancer registries. J Oral Maxillofac Pathol [Internet]. 2018 ;22(1):18–26.
3. Rosai, J., Ackerman, L. V., & Rosai, J. Rosai and Ackerman’s Surgical Pathology -. In: Rosai and Ackerman’s Surgical Pathology [Internet]. 11th ed. Edinburgh: Mosby; 2011.
4. Lin W-J, Jiang R-S, Wu S-H, Chen F-J, Liu S-A. Smoking, alcohol, and betel quid and oral cancer: a prospective cohort study. J Oncol. 2011;2011:525976.
5. Jornet PL, Garcia FJG, Berdugo ML, Perez FP, Lopez AP-F. Mouth self-examination in a population at risk of oral cancer. Aust Dent J. 2015 Mar;60(1):59–64.
6. Kim S, Christopher L, John B. The Hematoxylins and eosin & Immunohistochemical techniques. In: Bancroft’s Theory and Practice of Histological Techniques [Internet]. 7th Edition. Churchill Livingstone; 2012.
7. Shenoi R, Devrukhkar V, Chaudhuri, Sharma BK, Sapre SB, Chikhale A. Demographic and clinical profile of oral squamous cell carcinoma patients: a retrospective study. Indian J Cancer. 2012 Mar;49(1):21–6.
8. Takeda T, Sugihara K, Hirayama Y, Hirano M, Tanuma J-I, Semba I. Immunohistological evaluation of Ki-67, p63, CK19 and p53 expression in oral epithelial dysplasias. J Oral Pathol Med. 2006 Jul;35(6):369–75.
9. Elango JK, Gangadharan P, Sumithra S, Kuriakose MA. Trends of head and neck cancers in urban and rural India. Asian Pac J Cancer Prev. 2006 Mar;7(1):108–12.
10. Llewellyn CD, Johnson NW, Warnakulasuriya KA. Risk factors for squamous cell carcinoma of the oral cavity in young people--a comprehensive literature review. Oral Oncol. 2001 Jul;37(5):401–18.
11. Clinicopathological analysis of oral squamous cell carcinoma among the younger age group in coastal Karnataka, India: A retrospective study Abdulla R, Adyanthaya S, Kini P, Mohanty V, D’Souza N, Subbannayya Y - J Oral Maxillofac Pathol
12. Angiero F, Berenzi A, Benetti A, Rossi E, Del Sordo R, Sidoni A, et al. Expression of p16, p53 and Ki-67 proteins in the progression of epithelial dysplasia of the oral cavity. Anticancer Res. 2008 Oct;28(5A):2535–9.
13. AK E-N, JKC C, JR G, T T, PJ S. WHO Classification of Head and Neck Tumours. 4th ed. Vol. 9. IARC Publications; 2015 .
14. Tricker AR, Preussmann R. The occurrence of N-nitrosocompounds [corrected] in zarda tobacco. Cancer Lett. 1988 Oct;42(1–2):113–8.
15. Nair J, Ohshima H, Friesen M, Croisy A, Bhide SV, Bartsch H. Tobacco-specific and betel nut-specific N-nitroso compounds: occurrence in saliva and urine of betel quid chewers and formation in vitro by nitrosation of betel quid. Carcinogenesis. 1985 Feb;6(2):295–303.
16. Nair UJ, Floyd RA, Nair J, Bussachini V, Friesen M, Bartsch H. Formation of reactive oxygen species and of 8-hydroxydeoxyguanosine in DNA in vitro with betel quid ingredients. Chem Biol Interact. 1987;63(2):157–69.
17. Boffetta P, Mashberg A, Winkelmann R, Garfinkel L. Carcinogenic effect of tobacco smoking and alcohol drinking on anatomic sites of the oral cavity and oropharynx. International Journal of Cancer. 1992 Oct 21;52(4):530–3.
18. Blot WJ, McLaughlin JK, Winn DM. Smoking and Drinking in Relation to Oral and Pharyngeal Cancer. 1988;7.
19. Wynder EL, Stellman SD. Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977 Dec;37(12):4608–22.
20. Choi SY, Kahyo H. Effect of cigarette smoking and alcohol consumption in the aetiology of cancer of the oral cavity, pharynx and larynx. Int J Epidemiol. 1991 Dec;20(4):878–85.
21. Znaor A, Brennan P, Gajalakshmi V, Mathew A, Shanta V, Varghese C, et al. Independent and combined effects of tobacco smoking, chewing and alcohol drinking on the risk of oral, pharyngeal and esophageal cancers in Indian men. Int J Cancer. 2003 Jul 10;105(5):681–6.
22. Wey PD, Lotz MJ, Triedman LJ. Oral cancer in women nonusers of tobacco and alcohol. Cancer. 1987 Oct 1;60(7):1644–50.
23. Kruse AL, Bredell M, Grätz KW. Oral squamous cell carcinoma in non-smoking and non-drinking patients. Head Neck Oncol. 2010 Oct 4;2:24.
24. Cheng YW, Chiou HL, Sheu GT, Hsieh LL, Chen JT, Chen CY, et al. The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women. Cancer Res. 2001 Apr 1;61(7):2799–803.
25. Gealy R, Zhang L, Siegfried JM, Luketich JD, Keohavong P. Comparison of mutations in the p53 and K-ras genes in lung carcinomas from smoking and nonsmoking women. Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 1):297–302.
Published
2019-05-29
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
