Evaluation of serum lipids and lipoproteins as prognosticators in leukoplakia

Abstract

Background: Oral cancer is the 8th most common cancer worldwide. Squamous cell carcinomas constitute 94% of all oral malignancies and are often preceded by leukoplakia. Despite many adjunctive techniques to monitor transformation of leukoplakia to oral squamous cell carcinoma (OSCC), the mortality rate is on the rise. Incidentally, patients diagnosed with oral potentially malignant disorders (OPMDs) and oral cancers manifest with low choles-terol levels. Given a thought, hypolipidemia may be a useful adjunctive tool as it reflects the initial changes within the neo-plastic cells, thus giving a red alert in malignant transformation of leukoplakia at the earlier stage. Aim: To evaluate the feasibility of serum lipid profile as an adjunct early marker for malignant transformation of leukoplakia to OSCC. Objectives: To estimate the serum cholesterol, triglycerides and lipoprotein (HDL, LDL, VLDL) levels in patients with leukoplakia, OSCC and age matched healthy control group. To compare the serum cholesterol, triglycerides and lipoprotein levels between patients of leukoplakia, OSCC and age matched healthy control group. Materials and methods: The study group comprised of selected 30 individuals which included 10 each of histopathologically confirmed OSCC, leukoplakia and healthy controls. A written consent was taken from all of them, and a thorough case history was recorded and then venous blood was collected 12 hours post fasting and centrifuged. The serum cholesterol, triglycerides and HDL were estimated by enzymatic and colorimetric methods using commercially available kits - Roche/ Hitachi cobas systems. Chemistry assay QC procured from Bio-Rad was used as control. VLDL and LDL were derived from these values. Results were statistically analyzed using ANOVA and post hoc Tukey Test. Results: Oral squamous cell carcinoma patients demonstrated significantly lower mean serum cholesterol level (151.60 mg/dl) than the control group (183.70 mg/dl). The mean cholesterol level in leukoplakia patients (173.90 mg/dl) was lower than that of control group (183.70 mg/dl) but higher than that of the OSCC group (151.60 mg/dl) with no statistical significance. Conclusion: Convenience, universal availability, patient compatibility and simplicity being the merits of serum lipid profile make it a feasible adjunctive prognosticator in leukoplakic patients.