Evaluation of plasma fibrinogen degradation products and total serum protein concentration in oral submucous fibrosis

Total Serum Protein Estimation and Its Correlation with Clinical and Histopathological Grading using Masson's Trichrome Stain in Patients of Oral Submucous Fibrosis

Objectives:

Oral submucous fibrosis (OSMF) caused by dense deposition of collagen fibers which is a protein. There is a plethora of research to evaluate degree of collagen deposition using various simple histochemical techniques, but its correlation with total serum protein (TSP) level has not been explored so far.

Materials and Methods:

This case–control study comprised total forty samples with thirty cases of OSMF and ten cases were selected as control group, divided into four groups as per Lai et al. classification. Histological grading was also done according to the Rooban et al.'s classification. Blood sample was collected to evaluate TSP estimation. Findings were tabulated, and comparisons were made between clinical, histological, and TSP estimation. Discrete statistical data were analyzed by Chi-square test, ANOVA, and t-test with a statistical analysis package (SPSS version software 6.0).

Results:

No significant correlation was obtained between clinical staging and histopathological grading. Definite correlation was obtained in TSP and globulin levels of OSMF patients and their grades of fibrosis histopathologically.

Conclusion:

In the present study, it was observed that biochemical investigations involving assessment of TSP can be used as a diagnostic tool in OSMF, along with histopathological examination.

Effect of Habits and Nutritional Status on Clinical Grading and Histopathological Staging in Patients with Oral Sub Mucous Fibrosis

BACKGROUND

Oral submucous fibrosis (OSMF) is a chronic progressive debilitating disease affecting the oral, oropharyngeal and sometimes the oesophageal mucosa resulting in inability to eat due to burning, ulcers and stiffness.

AIM

The study was undertaken, to evaluate the correlation of clinical staging, histological grading and nutritional status using body mass index (BMI) with gutkha (habit) index in OSMF patients.

MATERIALS AND METHODS

The study group comprised of 50 patients clinically diagnosed and histopathologically confirmed cases of OSMF. Habit (gutkha) index was calculated by multiplying duration and frequency. Body mass index was calculated by dividing weight in kilograms and height in centimetres of the patient.

RESULTS

Male to female ratio was 2.8:1. Clinical grading increased with increase in gutkha index, patients with gutkha index 1-50, maximum were in mild stage; with gutkha index 51-100, maximum in moderate and patients with gutkha index 101-150, all were in severe stage. Histological staging showed direct correlation with gutkha index, it increased with increase in gutkha index with p <0.05. Site analysis showed that buccal mucosa and retromolar area were involved in all the patient and floor of mouth in 46% of patients Body mass index analysis revealed that out of 27 patients with moderate clinical staging 3 was underweight; out of 3 with severe clinical staging, 2 was underweight.

CONCLUSION

The duration and frequency of areca nut product use effects on the incidence and severity of OSMF and the patient becomes unable to eat due to burning, ulcers and inability to open mouth which affect the health of the individual. Thus it is important to access the nutritional status to improve the survival rate of patients.

Estimation of plasma fibrinogen degradation products in oral submucous fibrosis: A clinico-pathological study

Background:

Oral submucous fibrosis (OSF) is a disease of the oral mucosa characterized by excessive accumulation of subepithelial collagen, thereby resulting in severe limitation of mouth opening. In OSF, in response to inflammation, the body produces more fibrinogen and its degradation products. The plasma fibrinogen degradation products (FDP) have been reported to be early indicators of fibrin deposition. The present study was intended to ascertain the role of FDP in OSF.

Materials and Methods:

A total of 40 subjects were included in the study. The subjects for the present study were selected from the Department of Oral Medicine and Radiology. The subjects were divided into two groups. The study group comprised 24 subjects diagnosed clinically and histopathologically as OSF and were further divided into three clinical and histological stages of OSF. The control group comprised 16 age- and gender-matched healthy individuals. Five milliliters of venous blood was drawn from the antecubital fossa of all the participants. The blood samples were centrifuged at 1000 rpm for 5 min to separate plasma, and the plasma FDP levels were assessed.

Results and Conclusion:

There was a significant difference in the plasma FDP levels between the study group and the control group. There was a significant linear increase of plasma FDP levels with an increase in severity of the clinical stage of OSF. Comparison with the histopathological grades of OSF also showed an increase in FDP levels with higher grades of OSF and there was a good correlation between the clinical staging and the histopathological grading of OSF.

Plasma fibrinogen degradation products in oral submucous fibrosis

CONTEXT

Plasma fibrinogen degradation products (FDPs) and oral submucous fibrosis (OSMF).

BACKGROUND

OSMF is a chronic, progressive, scarring disease of multifactorial etiology. Areca nut is found to be the main cause of this disease. But it has been found in the routine clinical practice that some individuals with the habit of areca nut chewing may not show any clinical evidence of OSMF, while some individuals without the habit of areca nut chewing are found to have OSMF. So, there must be some other factors associated with OSMF. Recently, plasma FDPs have been identified as an early indicator of disease in OSMF patients. A systematic review of their role would help to elucidate whether there is an association of these FDPs in the pathogenesis of OSMF or not.

OBJECTIVE

To review studies reported in the literature elucidating the role of these plasma FDPs in OSMF.

MATERIALS AND METHODS

Articles were searched in PubMed; MEDLINE using appropriate key words like "plasma fibrinogen degradation products" and "oral submucous fibrosis." Hand search of journals was also performed. Articles were reviewed and analyzed.

RESULTS

The search strategy revealed nine relevant articles which studied the role of these plasma FDPs in the etiopathogenesis of OSMF and further progression of this disease with the increased clinical grades and the risk of carcinoma, but the exact role of these factors is still obscure.

CONCLUSION

The data validate the role of plasma FDPs in the etiopathogenesis of OSMF. Studies with a large sample size are still required to evaluate the definite association between these FDPs and OSMF. It has the advantage of being a noninvasive method to evaluate the stage of OSMF patients, instead of using the invasive techniques like biopsy.

Use of mid upper arm circumference for evaluation of nutritional status of OSMF patients

BACKGROUND

Oral submucous fibrosis (OSMF) is always associated with juxtaepithelial inflammatory reaction followed by fibroblastic changes in lamina propria, with epithelial atrophy leading to stiffness of oral mucosa and causing trismus and inability to eat. Mid upper arm circumference (MUAC) is a useful tool for a fast assessment of the nutritional status.

AIMS

The study was undertaken to evaluate the correlation of MUAC as a nutritional status indicator in OSMF patients.

PATIENTS AND METHODS

The study group comprised 50 clinically diagnosed and histopathologically confirmed cases of OSMF. MUAC was recorded using a plastic measuring tape. The right upper arm was measured at the midpoint between the tip of the shoulder and the tip of the elbow (olecranon process and the acromium).

RESULTS

Out of 50 subjects, 76% (38) were having MUAC value <23 cm, which shows an inverse relation between MUAC and clinical staging. The relation of MUAC with clinical staging was significant.

CONCLUSION

The patient with OSMF becomes unable to eat due to burning, ulcers, and inability to open mouth, which affects the health of the individual. Thus, it is crucial to access the nutritional status to improve the survival rate of patients.

Quantification of Plasma Fibrinogen Degradation Products in Areca Nut Chewers with and without Oral Submucous Fibrosis

INTRODUCTION

Fibrinogen degradation products (FDPs) are the products that are released from fibrin/fibrinogen. Recently, it has been observed that these FDPs have been identified in the plasma of OSMF patients. Areca nut being the major aetiological agent for OSMF may play a role in the increased plasma levels of FDPs in OSMF.

AIM

The aim of this study was to quantify the plasma FDPs levels in the individuals with the habit of areca nut chewing with and without OSMF.

MATERIALS & METHODS

Total of 95 subjects were included,35 subjects with the habit of areca nut chewing with OSMF, 30 with the habit of areca nut chewing without OSMF, 30 without any habit of areca nut chewing without OSMF (control group). Five ml of venous blood was withdrawn from all the subjects and plasma FDP levels were estimated.

RESULTS

Plasma FDPs were detected in all the subjects of OSMF but could not be detected in other two groups. As the clinical grades of OSMF increased, levels of plasma FDPs also increased.

CONCLUSION

When plasma FDP increases, fibrin deposition also increases. This strengthens the finding that these FDPs may be an early indicator of the OSMF.