Background Oral submucous fibrosis (OSF), distinguished by abnormal collagen deposition, is a potentially malignant disorder with 4.2% (95% CI 2.7–5.6%) of malignant transformation and rising global prevalence. However, the precise pathogenesis and effective treatment remain elusive and controversial despite the abundance of literature on this topic. Therefore, it is crucial to explore the clinicopathological characteristics and potential markers for the diagnosis and prognosis of OSF. The objective of this study was to evaluate the influence and correlation of Microfibrillar-associated protein 4 (MFAP4) and tropoelastin (TE) in the development of OSF patients. Material and methods Clinicopathological factors, hematoxylin–eosin (HE) and Masson trichome staining, immunohistochemical characteristics and the correlation between MFAP4 and TE were recorded and compared among different stages of OSF progression among cases (n = 60) and controls (n = 10). Student's t test, ANOVA analysis, and the chi-square test were performed to compare the categorical variables for clinicopathological characteristics and the expression level of MFAP4 and TE between the fibrotic and normal tissues. Correlation analysis of MFAP4 and TE was performed using Pearson's correlation test and linear regression. Results MFAP4 and TE proteins are upregulated and increased gradually in patients with varying stages of OSF, relative to the control group. Furthermore, statistical analyses revealed that the expression level of MFAP4 was positively associated with TE, with a Pearson correlation coefficient of 0.3781 (p = 0.0048). Clinically, we found that OSF affected more males than females, with a ratio of 29:1. The age range was 16–60 years, and the mean age was 36.25 ± 10.25 years. In patients younger than 40 years, the positive expression rate of MFAP4 and TE was higher than in those over 40 years. All OSF cases had chewed areca nut, with 51.67% smoking tobacco. Conclusions Our study elucidates that the accumulation of MFAP4 and TE proteins may play a vital role in the occurrence and development of OSF and may be promising candidate moleculars for prevention, diagnosis, and treatment strategies for OSF in the future.

Background: Oral submucous fibrosis (OSF), distinguished by abnormal collagen deposition, is a precancerous disorder with 7%-30% of malignant transformation and rising global prevalence. However, the precise pathogenesis and effective treatment still remains elusive and controversial despite superfluity of literature. Therefore, it is extremely necessary and significant to explore the clinicopathological characteristics and potential markers for diagnosis and prognosis of OSF. Here, the objective of this research is to evaluate the influence and correlation of Microfibrillar-associated protein 4 [MFAP4] and tropoelastin [TE] on the development of OSF patients. Material and Methods: Classic clinicopathological factors, HE and Masson trichome staining, immunohistochemical characteristics and the correlation (MFAP4 and TE) were recorded and compared among different stages of OSF cases (n = 60) and among those normal individuals (n = 10). Then, the comparison using Student's t test, ANOVA analysis, the chi-square test for categorical variables was conducted in clinicopathological characteristics and the expression level of MFAP4 and TE between the patients' and normal tissue. The correlation analysis of MFAP4 and TE were assessed via means of Pearson's correlation test and linear regression. Results: MFAP4 and TE proteins are upregulated and even increasing gradually in varying grades of OSF patients relative to the normal cases. Furthermore, statistical analyses yielded that the expression level of MFAP4 was positively associated with TE, and the Pearson correlation coefficient was 0.3781 (p = 0.0048). Clinically, we found that OSF affected more male than female with a ratio of 29: 1. The age range was 16-60 years, and the mean age was 36.25 ± 10.25 years old. Moreover, the positive expression rate of MFAP4 and TE in patients less than 40 years old is higher than that of those over 40 years old. Meanwhile, all OSF cases had chewed areca nut, with 51.67% smoking tobacco. Conclusions: Our study elucidates that the accumulation of MFAP4 and TE proteins may play a vitally important effect in the occurrence and development of OSF and has a hope to become a promising candidate molecular for prevention, diagnosis, and treatment strategies of OSF in the future.