Histomorphometric analysis of vascularity in oral epithelial dysplasia

Abstract

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