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CORRELATION OF INFLAMMATION AND VASCULARIZATION WITH ORAL LEUKOPLAKIA SEVERITY

Dr Kiran Pervez, Dr Rija Shahid, Dr Rameen Javaid

Background and purpose: Variation in sub-mucosal vascularization and inflammatory changes detected with immunohistochemical staining have been shown to be associated with the development of dysplasia and invasiveness of epithelial cells in precancerous and malignant lesions. This study looked at changes in areas routinely stained with hematoxylin and eosin (H&E) during oral leukoplakia and progression of squamous cell carcinoma (SCC). ). The aim of the study was to determine whether changes in H&E routine color change in submucosal vascularization and leukoplakia inflammatory infiltration could contribute to assessing the severity of the lesion. Place and Duration: In the Department of Oral, Dental, Maxillofacial and Pathology Mayo Hospital Lahore for one year duration from March 2018 to March 2019. Methods: In this cross-sectional, descriptive and comparative study, total of 125 sample which includes 35 cases of mild to moderate dysplasia, 38 severe dysplasia and 52 cancer in situ cases and were examined, stained with H and E. To analyze the data, the chi-square test, Mann-Whitney test, Kruskal-Wallis test and cumulative sequential logistic regression were performed. Results: Patients with severe dysplasia, cancer in situ and SCC had significantly higher vascular density than patients with mild to moderate dysplasia (p <0.0001). However, the difference in vascularization was not statistically significant between severe dysplasia, cancer in situ and SCC (p = 0.78). The inflammatory cell infiltration intensity in underlying connective tissue was significantly different between the three groups (P <0.0001), and the density of inflammatory cell infiltration was maximum in the SCC group. Conclusion: Increased inflammatory cell infiltration and submucosal vascularization may additionally subsidize to the prognosis of more aggressive epithelial dysplasia.