Histopathological Appearances of Oral Squamous Cell Carcinoma: Relationship with Tobacco Chewing Carcinogens

Abstract

Objective: This study is focused to explore the histopathological conditions of oral squamous cell carcinoma (OSCC), with a history of chewing gutka, manpuri, niswar, raw tobacco, paan and chaliya in sequence to explicate the association of chewing materials with histopathological appearances.

Methods: A total of 260 biopsies were collected from OSCC patients with informed consent and studied for histopathology, by acquiring standard protocols. Blood and tissue samples of OSCC patients were collected from Abbasi Shaheed Hospital, Civil Hospital, Darul Sehat Hospital, Jinnah Postgraduate Medical Centre, and OMI Hospital, Karachi. The questionnaire used in the interview had detailed information on current and past cigarette smoking and chewing habits history, medical, occupational, family disease and dietary history and the general demographic data. The metastatic ulcerated lesions were surgically dissected by an expert surgeon, collected in sterile plastic containers, and stored at -80°C until DNA extraction. A separate piece of tissue was also dissected and preserved in formalin. Formalin-preserved tissue samples were sent for the histopathological examination.

Results: Pearson chi-square showed significant association between habitual chewing materials and different histopathological appearances (²= 18.92 p<0.05). Moreover, the odds ratio (OR) for developing OSCC was found significantly higher among all chewing habits with different histopathology; for invasive SCC, gutka (OR: 2.36) showed a significant odds ratio as compared to other chewing materials; for microinvasive SCC, significant odds were observed in paan (OR: 1.97), chaliya (1.57), raw tobacco (1.21) and niswar (1.06), while the odds ratio for intraepithelial was significant in chaliya (3.86), manpuri(1.64) and niswar (1.30) respectively.

Conclusions: Our study confirms that the use of chewing materials like gutka, manpuri, niswar and other related products is responsible for developing different histopathological outcomes of OSCC. The results of this research may provide the understanding of the histopathological conditions of OSCC.