Prevalence of fungal hyphae in potentially malignant lesions and conditions-does its occurrence play a role in epithelial dysplasia?

Abstract

Background:Oral cancer is a major public health problem in India. A key factor that has led to lack of improvement in prognosis of oral cancer over the years, is delay in diagnosis and treatment. In many instances, a significant proportion of oral squamous cell carcinomas develop from premalignant lesions and conditions. Identification of such lesions and conditions is very important in order to prevent malignant transformation. The role of fungal infections has been studied and holds promise as an indicator to predict malignant transformation. So we designed a study to analyze the prevalence of fungal hyphae in biopsies of patients with clinically diagnosed cases of premalignant lesions and conditions.Aims and Objectives:To determine and compare the prevalence of fungal hyphae in biopsies of patients with clinically diagnosed cases of potentially malignant lesions and conditions and to assess the possible association between the degree of epithelial dysplasia and presence or absence of fungal hyphae.Materials and Methods:Clinically suspected and histopathologically diagnosed 70 cases of potentially malignant lesions and conditions (29 leukoplakia, 16 submucous fibrosis and 25 lichen planus) made up the study group. Three tissue sections (5μm) of each were stained with hematoxylin and eosin (H and E), periodic acid–Schiff's reagent (PAS) and Grocott's methenamine silver (GMS) and evaluated for fungal hyphae. The data collected was statistically analyzed by using Chi-square test and Statistical Package for Social Sciences (SPSS) software.Results:The estimated prevalence of fungal hyphae in cases with or without dysplasia in leukoplakia was 41.4%, lichen planus 36% and submucous fibrosis 25%. There was a significant association between degree of epithelial dysplasia with presence or absence of fungal hyphae in all the study groups.Conclusion:Presence of fungal hyphae in potentially malignant lesions and conditions may prove to be a useful indicator in predicting malignant transformation.

Evaluation of candidal species among individuals with oral potentially malignant disorders and oral squamous cell carcinoma

“…In the present study, the presence of Candida in SDA medium showed maximum specimens from OSCC followed by PMD and least in controls. Similarly, the results were demonstrated by various investigators such as Hongal et al .,[12] Saigal et al .,[1] Anila et al . [25] and Vučković et al .…”

“…Few investigators have also indicated that the presence of candidal infection increases the risk of malignant transformation in premalignant lesions. [12] Yeasts are common commensal organisms found in approximately 40% of individuals, the predominant species isolated being C. albicans . C. albicans predominantly affects oral mucosa.…”

“…Few studies have also indicated that the presence of candidal infection increases the risk of malignant transformation in premalignant lesions. [91213] It was proved that Candida plays a role in the development of cancer production by endogenous nitrosamine production which activates proto-oncogenes. [1]…”

Candida in malignant transformation of oral leukoplakia: A review

“…[26] These findings propound a convincing association between leukoplakia and Candida species which was first reported in 1965 by Cernea et al, and Jepsen and Winther. [22] Colonization of Candida species in oral leukoplakia was studied by Sarkar et al by employing direct microscopy and histopathological diagnostic methods to ascertain the statistical correlation between candidal invasion and epithelial dysplasia. Year Types of Candida species Daftary et al [13] 1972 Candida albicans Krogh [14] 1990 Candida albicans, Candida tropicalis, Candida parapsilosis…”

Microenvironmental regulation of the progression of oral potentially malignant disorders towards malignancy

“…For example, the prevalence of Candida infection in OLK, erosive OLP, and OSF is 47%, 44.29%, and 36.67%, respectively [ 33 – 35 ]. Other infections may be associated with OPMD such as Helicobacter pylori [ 36 ], HCV [ 37 ], and fungal hyphae [ 38 ], and the infection rate is about 90% [ 36 ], 23% [ 37 ], and over 25% [ 38 ], respectively.…”