Clinical and Histopathological Correlation Between Dysplastic Changes in Oral Potentially Malignant Lesions and Presence of Candida albicans

Abstract

Background: The concept of a two-step process of cancer development in the oral mucosa, starting with an initial presence of a precursor (premalignant, precancerous) lesion which is subsequently develops into frank cancer, is a well-established con-cept,red lesions such as erythroplakia, leukoerythroplakia, verrucous lesions and ulcer-ative lesions may represent higher risk, whereas homogenous leukoplakia carries a lower risk dysplasia or malignancy at diagnosis. Candida albicans is a highly versatile commensal organism that is well adapted to its human host transition from one of commensals to pathogen, the role of Candida albicans as a possible etiological factor in leukoplakia and its possible role in malignant transformation is still unclear. Aims of this study is to look at the epidemiological features of PMOLs and their clini-cal presentation and to determine the prevalence of fungal hyphae in 30 tissue sections. Materials and methods: Data of the clinically suspected and histopath-ologically confirmed 90 (4.7%) cases from total of 1894 biopsied lesions in the period from 1998 to 2010 were obtained from the department archives. Furthermore, thirty biopsies from those were stained with (H & E) first then with PAS stain to look for candidal hyphae. Results: From these 90 cases, 62 (68.8%) of them were OLP, 20 (22.2%) OLEP, 3 (3.3%) of VL and 2 (2.2%) cases of OSMF. Whereas OEP, actinic cheilitis. Candidial leukoplakia were detected in only one case. Dysplastic changes with varying degrees were noticed in almost all the biopsies except one. Mostly mild 20 cases, moderate 6 cases and severe in 3 biopsies. Candida hyphae were detected in only 2 cases the yeast (blastospore) represented 6.6% of these case in candidal leukoplakia and verrucous leukoplakia cases. Conclusion: Fungal hyphae in the potentially malignant lesions and conditions is not useful indicator in predicting malignant transformation. The presence of epithelial dys-plasia is more important in predicting malignant transformations than the clinical char-acteristics of the lesion.