Decoding the Predictors of Dysplastic Changes in Oral Submucous Fibrosis: A Cross-Sectional Study
DOI:
https://doi.org/10.31580/pjmls.v8isp3496Keywords:
Areca nut, Epithelial dysplasia, Oral cancer, Oral submucous fibrosis, Potentially malignant disorders, Risk factorsAbstract
Background: Oral submucous fibrosis (OSMF) is a chronic, progressive, potentially malignant oral condition strongly linked to areca nut use. Since epithelial dysplasia predicts malignant transformation, this study identified factors associated with dysplastic changes in OSMF patients.
Methodology: This cross-sectional analytical study was conducted in a diagnostic laboratory affiliated with Punjab University, Lahore, over six months. Using non-probability consecutive sampling, 120 patients clinically diagnosed with OSMF were enrolled. Demographic data, length and frequency of areca nut use, tobacco exposure, mouth opening, burning sensation scores and clinical staging were recorded. Incisional biopsies were undertaken for diagnosis and the grade of epithelial dysplasia. The SPSS (version 26.0) software was used to analyze the data. Predictors of dysplastic changes were identified using chi-square test, independent t-test, and multivariate logistic regression analysis. A p-value ≤0.05 was considered statistically significant.
Results: The mean age of participants was 36.8 ± 9.7 years and 71.7% of the participants were male. Histopathological examinations showed 44 (36.7%) patients had epithelial dysplasia. There was a significant increase in people who have been chewing areca nuts for more than 10 years, chewed more than five times a day (p=0.014), used tobacco at the same time (p=0.026), had a more advanced stage of OSMF, and had decreased opening of the mouth (disability) (p<0.05). Advanced clinical stage (OR=3.82, 95% CI: 1.89–7.73), tobacco use (OR=2.94, 95% CI: 1.36–6.34) and consumption of areca nut for more than 10 years (OR=3.27, 95% CI: 1.54–6.96) were independent factors associated with epithelial dysplasia.
Conclusion: Advanced clinical stage, prolonged areca nut exposure, and concomitant tobacco use were significant predictors of dysplastic changes in patients with OSMF.
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