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Better grade of tumor differentiation of oral squamous cell carcinoma arising in background of oral submucous fibrosis.
[oral submucous fibrosis]
Oral
submucous
fibrosis
(
OSMF
)
is
a
potentially
malignant
disorder
of
the
oral
cavity
.
Most
of
the
people
affected
by
OSMF
are
betel
quid
chewers
.
It
is
characterized
by
epithelial
atrophy
and
progressive
accumulation
of
collagen
fibers
in
lamina
propria
and
submucosa
of
the
oral
mucosa
.
7
.
6
%
of
OSMF
cases
undergo
oral
squamous
cell
carcinoma
(
OSCC
)
transformation
of
which
majority
display
low
grade
of
tumor
differentiation
.
In
the
present
paper
,
a
hypothesis
has
been
proposed
to
correlate
atrophy
,
turnover
rate
and
surface
keratization
in
OSMF
with
degree
of
tumor
differentiation
in
OSCC
.
A
novel
hypothesis
for
epithelial
atrophy
in
OSMF
has
also
been
emphasized
.
High
proliferative
activity
and
basal
cell
hyperplasia
in
conjunction
with
rapid
exfoliation
of
superficial
cells
and
epithelial
atrophy
suggest
that
epithelial
turnover
rate
is
very
high
in
OSMF
.
Presence
of
surface
keratinized
layer
in
this
situation
suggests
faster
maturation
or
differentiation
of
epithelium
in
OSMF
.
Thus
,
the
epithelial
cells
are
genetically
programmed
for
high
turnover
rate
and
faster
differentiation
or
maturation
to
form
keratin
.
During
malignant
transformation
of
OSMF
,
the
transformed
epithelial
cells
may
retain
the
genetic
memory
of
faster
differentiation
and
maturation
resulting
in
better
grade
of
tumor
differentiation
.
The
well
differentiated
OSCC
has
good
prognosis
,
better
survival
rate
and
less
chances
of
recurrence
of
regional
and
distant
metastasis
.
Studies
are
needed
to
explore
the
biomarkers
or
molecular
markers
associated
with
carcinogenesis
like
genetic
instability
,
oncogenes
,
tumor
suppressor
genes
and
angiogenesis
in
OSCC
associated
with
OSMF
.
If
investigated
in
the
suggested
direction
,
it
might
provide
some
important
clues
about
the
pathogenesis
of
OSCC
arising
in
background
of
OSMF
and
for
the
future
development
of
treatment
strategies
.
Diseases
Validation
Diseases presenting
"oral mucosa"
symptom
child syndrome
cowden syndrome
dystrophic epidermolysis bullosa
erythropoietic protoporphyria
kindler syndrome
oligodontia
oral submucous fibrosis
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