Evaluation Of Risk Factors and Biological Markers Related To Oral Epithelial Dysplasia and Squamous Cell Carcinoma: Case Control Study

Background: Oral squamous cell carcinoma is recognized as a public health concern worldwide. It is the sixth most common malignancy which recorded 90% of all oral malignant tumors causing a significant number of cancer related death every year. The late diagnosis and lack of specific biomarkers for predicting the tumor progression and patient's prognosis could be the cause of the high mortality rate. Objectives: To assess the oral epithelial dysplasia and squamous cell carcinoma (OSCC) risk factors and evaluate immunohistochemically the over expression of P53 in cases of oral epithelial dysplasia and OSCC and correlate it with the expression of the immune cell infiltrate (CD4 and CD8) in the same lesions. Methodology: A case control study was conducted on (25) cases of oral epithelial dysplasia and (35) case with oral squamous cell carcinoma compared with (240) participants as a control group who was matched with age gender and smoking status. Data were collected by interview administrated questionnaire, clinical examination and immunohistochemistry. The immunohistochemistry was done on (60) samples from cases and (60) randomly samples from control group. Results: Smoking, oral hygiene practice and periodontal conditions considered risk factors for oral cancer. The expression of CD4+ and CD8+ was increased with the transformation from normal epithelium to dysplastic epithelium and squamous cell carcinoma, this expression was significantly correlated with P53 immunostaining at p (< 0.000). Conclusion: The most detected risk factors related to OSCC were the frequency and duration of smoking, bad oral hygiene, sever periodontitis and low educational level. Public awareness is needed among these targeted groups to prevent oral cancer. The increase in the expression of CD4+, CD8 + with epithelial transformation from normal to dysplastic or squamous cell carcinoma and its correlation with the over expression of P53 may have a potential significant role as biological markers of malignant transformation and carcinogenesis, and it could potentially be utilized in the treatment of oral squamous cell carcinoma.