Quantitative analysis of C-reactive protein in potentially malignant disorders: A pilot study

Background: Recent advances in understanding complex tumor interactions have led to the discovery of an association between inflammation and cancer. An abundance of pro - inflammatory cytokines in a tumor micro-environment can lead to angiogenesis, thus favoring neoplastic growth. Serum C reactive protein is a sensitive marker of inflammation and may have significant prognostic value as early biomarker for cancer diagnostics. Aims and Objectives: This was a pilot study done to assess the serum C reactive protein levels in potentially malignant disorders (PMDS) and to evaluate their role as prognostic marker. Materials and Methods: The study sample consisted of 20 cases of oral potentially malignant disorders (10 each of Leukoplakia, Oral Sub mucous fibrosis) confirmed by histopathological examination and 10 controls. All the samples were subjected to C - reactive protein analysis by immunoturbidometery. Results were subjected to Statistical analysis. Statistical analysis: Data was entered in data base management of the software SPSS version 20.0. Comparison of three groups with respect to C reactive protein levels was done by one way ANOVA. Pair wise comparison of three groups was done by Turkeys multiple post hoc procedure. Results: Mean C reactive protein levels in leukoplakia was 0.33±0.17, in oral submucous fibrosis was 0.58±0.83 where as in controls it was 0.26±0.05. In potentially malignant disorders, C reactive protein was slightly elevated when compared with the controls. Conclusion: Our findings demonstrate that serum C reactive protein concentration is associated with subsequent development of oral cancer and could serve as a potential prognostic biomarker

Histomorphometric analysis of vascularity in oral epithelial dysplasia

Context: Potentially malignant disorders such as leukoplakia and erythroplakia are often associated with dysplastic changes that have an increased risk for malignant transformation. Vascularity could have a role in the transformation of potentially malignant disorders to oral squamous cell carcinoma. Aims: The present study was aimed to assess the mean vessel area (MVA) of the blood capillaries in different grades of epithelial dysplasia by histomorphometric analysis, which could aid in predicting the malignant transforming potential as well as prognosis of potentially malignant disorders. Materials and Methods: The study consisted of 30 histologically proven epithelial dysplasia cases categorized into three groups of mild, moderate, and severe epithelial dysplasia based on the World Health Organization (WHO) 2005 criteria. Paraffin-embedded tissue sections of 3-4 microns were stained with Masson′s trichrome. Morphometric analysis of MVA was done using image analysis software 6.0. Statistical Analysis Used: Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) 20.0. The mean and standard deviation of the three groups were analyzed using Kruskal-Wallis analysis of variance (ANOVA) test. Pairwise comparison was done using Mann-Whitney U test. P value <0.05 was considered to be statistically significant. Results: The MVA was highest in severe epithelial dysplasia (7575.16) followed by moderate (4070.4) and mild (4014.29) epithelial dysplasias. A high statistical significance was observed on comparison of the three groups (P 0.0004). On pairwise comparison, a statistical significance was observed between mild and severe epithelial dysplasias (P 0.0032) and moderate and severe epithelial dysplasias (P 0.0002). Conclusions: The MVA was increased as the grade of dysplasia progressed. This suggests that altered vascularity could play a role in the progression and malignant potential of dysplastic lesions and also in assessing the prognosis