A miscellany of cribriform pattern, squamous metaplasia and clear cells in pleomorphic adenoma of upper lip: A diagnostic paradox.

CONTEXT: Early detection of oral squamous cell carcinoma (OSCC) and oral submucous fibrosis (OSMF) transforming into malignancy can drastically improve the treatment outcomes and prognosis. Carcinoma development is an intricate complex mechanism and the multifactorial causation makes it more difficult to find specific prognostic and therapeutic biomarkers. Thus, the development of newer diagnostic and predictive approaches that are less invasive, economical and amenable to repeated sampling is imperative. Serum C-reactive protein (CRP) serves a useful marker for prognosis and monitoring of oral potentially malignant disorders (OPMDs) including OSMF as well as OSCC. Secreted by hepatocyte as an acute inflammatory marker, various studies have shown association between serum CRP and presence of OPMDs, as well as with presence and prognosis of OSCC.

AIMS: The aim of this study was to measure and compare serum CRP levels in patients with OSMF and OSCC as compared to healthy individuals and to establish baseline data for serum CRP levels in patients with OSMF and OSCC.

SETTINGS AND

DESIGN

Cross-sectional observational prospective study.

MATERIALS AND METHODOLOGY: The study includes 150 individuals, with 50 healthy, 50 OSMF and 50 OSCC individuals. Spinreact CRP-turbilatex Kit (SPINREACT) and Prietest-EXP semi-automatic biochemical analyzer were used for quantitative determination of serum CRP.

STATISTICAL ANALYSIS USED: Data were analyzed by SPSS 16© (Statistical Package for the Social Sciences) software.

RESULTS

The mean value of serum CRP in Group I was 2.20 mg/L with standard deviation of 1.74; in Group II, it was 5.40 mg/L with standard deviation of 4.79 mg/L and in Group III, it was 12.17 mg/L with standard deviation of 11.38.

CONCLUSIONS

Serum CRP levels in patients with OSMF were raised, but not statistically significant as compared to the control group. Values of serum CRP were significantly higher in patients with OSCC as compared to the control group, and it was statistically significant; these values also showed positive association with primary tumor size.