No abstract

Background: Oral submucous fibrosis (OSF) is an oral potentially malignant disorder depicting extensive fibrosis of the submucosa affecting most parts of the oral cavity, including pharynx and upper third of the oesophagus. Despite its high potentially malignant nature, transformation of the epithelium towards malignancy in the background of fibrosis has not been studied extensively till date. Hypoxia Inducible Factor-1α (HIF-1α) is a master transcription factor that is induced by hypoxia and has found to be significantly associated with both fibrosis and malignancy. Aim: To test the hypothesis of differential expression of HIF-1α in malignant transformation of OSF. Materials and methods: Fifteen samples each of Normal Mucosa (NOM), OSF and Oral Squamous Cell Carcinoma (OSCC) making total of 45 tissues were studied by formalin fixed Haematoxylin and Eosin (H&E)-stained sections and frozen fixed for Reverse Transcription Polymerase Chain Reaction (RT-PCR). The relationship between differential HIF-1α messenger RNA expression level and oral epithelial dysplasia, inter incisal opening and grade of OSCC was studied. Conclusions: An upregulation of HIF-1α expression level is positively correlated with oral carcinogenesis and grade of OSCC, whereas downregulation is associated with fibrosis. Hence, it can be used as both diagnostic as well as a prognostic marker.