Quantitative DNA Assay (Ploidy), Koilocytotic Changes and AgNOR Expression for Risk Estimation in Oral Leukoplakia

In this study, quantitative DNA estimation (DNA ploidy), AgNORs and koilocytotic changes were assessed in oral leukoplakia for risk categorization. Materials and methods: 50 cases of oral leukoplakias along with adequate controls were selected for the study. Quantitative DNA analysis was done by FACS scan. AgNORs were studied by silver staining method, koilocytotic changes and histopathology were studied in HE stained tissue sections. Results: Out of 50 cases, 45 cases (90%) were linked to traditional addiction of various forms and 5 cases (10%) were non-addicts. Histologically, there were 52% non dysplastic and 48% dysplastic cases. Out of these 50 cases, there were diploid, tetrapoid and aneuploid population including hypodiploid DNA content. The DNA index (DI), among these cases, were ranged from 0.22 (hypodiploid) to 2.12 (tetrapoid) (co-efficient of variation ranged from 0.39 to 18.43). The mean AgNOR count for smokers were 3.5 ± 2.058 whereas the mean AgNOR count for the betel quid group was 2.85 ± 1.47 and for khainigutka group was 3.67 ± 2.21. Less than 50% cases showed positivity for koilocytotic changes (20 out of 50 cases). Conclusion: The quantitative DNA (ploidy) study along with AgNORs can be considered dually as a prospective prognostic marker for cancer risk prediction in cases of oral leukoplakia. But koilocytotic changes for the HPV association as a marker for risk prediction in cases of oral leukoplakia is controversial and needs to be investigated on a large scale basis and follow up for a longer duration.