Correlation Between Clinical and Histopathologic Diagnosis of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma

Knowledge about dental care in patients with head and neck cancer among senior dental school students: a cross-sectional descriptive study

BACKGROUND

The dentist's central role in treating head and neck cancer patients is to care for the patient's oral cavity before, during, and after radio/chemotherapy. This research aimed to determine dental students' knowledge about head and neck cancer patients' dental care.

METHODS

One hundred and four fifth and sixth-year dental students participated in this cross-sectional descriptive study. The data collection tool was a questionnaire that collected demographic information (gender, year of study) and four questions consisting of attendance to courses or workshops, passing a dedicated course at the university, willing to participate in a course or workshop on the treatment of head and neck cancer patients and self-evaluating information about the treatment of head and neck cancer patients. Final part 36 questions about oral and dental care for head and neck cancer patients before, after, and during treatment. The data were analyzed with SPSS 26 statistical software and using t-tests, ANOVA, and linear regression at the 0.05 significance level.

RESULTS

Most of the participants were in their sixth year (48.9%). A total of 48.1% of the people reported that their information about dental treatments in patients with head and neck cancer was bad. 85% of participants agreed with the necessity of evaluating the patient's mouth and teeth before starting the treatment. The lowest percentage of correct answers was related to the ideal duration of tooth extraction and a poor prognosis before the start of cancer treatment. The regression analysis revealed a significant relationship between years of education, willingness to participate in courses, and students' knowledge evaluation and knowledge.

CONCLUSION

The findings showed that students' awareness of oral and dental treatment and care for patients with head and neck cancer is insufficient. It is recommended that teaching staff pay more attention to the lack of knowledge and effort to educate students by holding special courses and workshops.

Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India

Background

There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion.

Materials and methods

A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis.

Results

Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study.

Conclusion

Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.

Description of clinicopathological characteristics of oral potentially malignant disorders with special focus on two histopathologic grading systems and subepithelial inflammatory infiltrate

OBJECTIVE

This study was conducted to evaluate the clinicopathological features of oral potentially malignant disorders (OPMDs) with a focus on two histologic grading systems and subepithelial inflammatory infiltrates.

MATERIALS AND METHODS

This cross-sectional and multicenter study was conducted from April 2016 to September 2021 and comprised patients diagnosed with OPMDs. Hematoxylin and eosin-stained slides of 127 cases were assessed based on the World Health Organization (WHO) 2005 classification system, namely, epithelial precursor lesions and binary system of oral epithelial dysplasia (OED). Chi-square test and Fisher's exact test were used to compare different categorical variables related to OPMDs.

RESULTS

The mean age of OPMD cases at presentation was 54.72 13.30 (P < 0.01) with a male to female ratio of 1.6:1. Oral leukoplakia (52.8%) was the most commonly diagnosed form of OPMD. Most OPMDs were classified as oral epithelial hyperplasia (59.1%) and the remaining (40.9%) as OED (P < 0.01). Of the 52 OPMDs with OED, all cases of mild dysplasia (36.5%) and carcinoma in situ (9.6%) were categorized as low-risk and high-risk lesions, respectively. Chronic inflammatory infiltrate (79.5%) was the most common subepithelial inflammatory alteration observed among OPMDs.

CONCLUSIONS

Early detection of OPMDs is vital due to increased risk of developing into oral cancer. Timely clinicopathological risk assessment of OPMD is desirable for improving the prognosis and preventing the malignant transformation in oral premalignancy. Besides the epithelial precursor lesions' classification by the WHO, binary system of grading OED use can be encouraged. Also, subepithelial inflammatory infiltrate can be of importance in future research regarding OPMDs.