Correlation between Vascularity and Advancing Histological Grades of Oral Submucous Fibrosis with a Plausible Role in Malignisation: Systematic review of a persisting matter of conflict

Deepak Pandiar ¹, Suvarna K Nair ¹, Ronell Bologna-Molina ²

⁰Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.

Sultan Qaboos University Medical Journal +

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June 3, 2024

View abstract on PubMed

Summary

Vascularity in oral submucous fibrosis (OSMF) decreases with advanced stages, challenging theories linking increased blood vessel formation to cancer development. This finding impacts understanding of OSMF progression and malignancy risk.

Area Of Science

Oral pathology
Oncology
Histopathology

Background

Oral submucous fibrosis (OSMF) is a potentially malignant disorder.
The relationship between vascularity and OSMF progression to malignancy is debated.
Conventional concepts suggest increased vascularity with disease advancement.

Purpose Of The Study

To quantify vascularity across histological grades of OSMF.
To investigate the link between vasculogenesis and OSMF malignancy.
To evaluate current literature on vascularity changes in OSMF stages.

Main Methods

Systematic review of published articles until December 2022.
Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Screening of 98 articles, with 13 included for evaluation (607 cases).

Main Results

Vascularity, including mean vascular density, decreased in more than half of the evaluated studies as OSMF stage advanced.
Similar trends observed for endothelial cells/μm², mean vascular area percentage, and mean vascular area.
The majority of included studies (11 of 13) assessed mean vascular density.

Conclusions

The review supports the concept that vascularity diminishes with advancing OSMF stages.
This finding contradicts theories suggesting increased vascularity facilitates carcinogen absorption and malignancy.
Reduced vascularity may imply altered mechanisms in OSMF progression to cancer.

Keywords:

Fibrosis Oral Submucous Fibrosis Vascularity