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Immunohistochemical expression of CD34 and basic fibroblast growth factor (bFGF) in oral submucous fibrosis.
[oral submucous fibrosis]
Oral
submucous
fibrosis
(
OSMF
)
is
an
insidious
chronic
fibrotic
condition
that
involves
the
oral
mucosa
and
occasionally
the
pharynx
and
esophagus
.
Vascularity
in
OSMF
has
always
been
a
matter
of
debate
.
The
prevailing
concept
is
that
epithelial
atrophy
occurs
due
to
lack
of
perfusion
but
the
recent
data
challenges
this
concept
.
Therefore
,
the
present
study
was
conducted
to
evaluate
the
immunoreactivity
of
CD
34
and
basic
fibroblast
growth
factor
(
bFGF
)
in
different
histological
grades
of
OSMF
.
This
might
further
shed
light
to
the
role
of
microvasculature
in
OSMF
,
so
that
the
epithelial
atrophy
and
resultant
malignant
transformation
seen
in
the
advanced
stages
might
be
elucidated
.
A
total
of
30
cases
of
OSMF
were
included
in
the
study
and
mean
vascular
density
(
MVD
)
was
calculated
using
CD
34
and
bFGF
.
Five
cases
of
OSMF
with
dysplasia
and
2
cases
of
OSMF
turning
malignant
were
added
during
the
course
of
the
study
.
Mean
vascular
density
was
found
to
decrease
significantly
as
the
diseases
advanced
.
Furthermore
,
vascularity
increased
significantly
in
cases
of
OSMF
turning
towards
malignancy
.
Our
study
supports
the
concept
of
epithelial
atrophy
aftermath
of
lack
of
perfusion
.
There
is
reduced
vascularity
as
the
disease
advances
and
this
denies
the
systemic
absorption
of
carcinogens
,
which
affects
the
already
compromised
epithelium
.
Consequently
,
liberation
of
angiogenic
factors
occurs
because
of
malignant
transformation
,
which
explains
the
neoangiogenesis
and
increased
vascularity
in
OSMF
turning
towards
malignancy
.
Further
studies
are
required
to
identify
the
mechanism
leading
to
carcinogenesis
in
the
atrophied
epithelium
aftermath
of
fibrosis
and
decreased
vascularity
.
Diseases
Validation
Diseases presenting
"malignant transformation"
symptom
achondroplasia
adrenal incidentaloma
child syndrome
cholangiocarcinoma
cutaneous mastocytosis
epidermolysis bullosa simplex
esophageal adenocarcinoma
liposarcoma
oral submucous fibrosis
severe combined immunodeficiency
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