Non-invasive strategies that can identify oral malignant and dysplastic oral potentially-malignant lesions (OPML) are necessary in cancer screening and long-term surveillance. Optical coherence tomography (OCT) can be a rapid, real time and non-invasive imaging method for frequent patient surveillance. Here, we report the validation of a portable, robust OCT device in 232 patients (lesions: 347) in different clinical settings. The device deployed with algorithm-based automated diagnosis, showed efficacy in delineation of oral benign and normal (n = 151), OPML (n = 121), and malignant lesions (n = 75) in community and tertiary care settings. This study showed that OCT images analyzed by automated image processing algorithm could distinguish the dysplastic-OPML and malignant lesions with a sensitivity of 95% and 93%, respectively. Furthermore, we explored the ability of multiple (n = 14) artificial neural network (ANN) based feature extraction techniques for delineation high grade-OPML (moderate/severe dysplasia). The support vector machine (SVM) model built over ANN, delineated high-grade dysplasia with sensitivity of 83%, which in turn, can be employed to triage patients for tertiary care. The study provides evidence towards the utility of the robust and low-cost OCT instrument as a point-of-care device in resource-constrained settings and the potential clinical application of device in screening and surveillance of oral cancer.

A BSTRACT: Introduction: Oral potentially malignant disorders (OPMDs), including leukoplakia, oral submucous fibrosis, and erythroplakia, are precursors to oral cancer, a major public health issue in India. The primary etiological factors for OPMDs are the use of tobacco (smoking and smokeless) and alcohol consumption, which are deeply embedded in cultural practices and contribute significantly to the rising incidence of oral cancer. The Cigarettes and Other Tobacco Products Act (COTPA) of 2003 aims to regulate tobacco usage, but implementation remains inconsistent, particularly in rural areas. This study explores the correlation between these adverse habits and OPMDs in an Indian population, aiming to develop a classification system for high-risk patients. Materials and Methods: A cross-sectional study included 262 patients diagnosed with OPMDs and 100 control subjects with a history of adverse habits but no clinically visible lesions. Patient data was collected through questionnaires and medical records from the Department of Head and Neck Oncology in Kolkata, with statistical analysis performed using SYSTAT software to compare age, sex, habit history, and the prevalence of OPMDs across groups. Results: The mean age of OPMD patients was 38 years, with 100% male patients. Tobacco use (both smoking and smokeless) and alcohol consumption were significantly more prevalent in the OPMD group compared to controls. The most common clinical diagnosis was homogeneous leukoplakia, with mild dysplasia being the most frequent histopathological finding. Statistical analysis revealed a strong association between adverse habits and OPMD diagnosis. Conclusion: This study underscores the significant role of tobacco and alcohol in the development of OPMDs and OSCC. A classification system based on demographics, habit history, and socio-economic status is proposed for effective triaging of high-risk individuals. This could enhance early detection and intervention, particularly in high-risk populations, thereby contributing to oral cancer prevention.

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) have an annual malignant transformation rate of 0.5–2.1%. Lichenoid dysplasia (LD) appears clinically similar to OLP, OLL but histologically harbors atypical cells for which it has a greater potential for malignant transformation. The case reports of two female patients are reported here, which were clinically diagnosed as OLP, later as LD following histopathological confirmation. Both had positive tobacco history and extensive intra-oral lesions. Habit cessation was supplemented by non-steroidal therapeutics with periodic follow-up. There was reduction in the burning sensation, lesion size, and the degree of inflammation of the lesions. Clinical lichenoid like features warrants a biopsy to rule out OLP, OLL from LD. Except for palliation, lesion oriented proper therapeutic treatment should be instituted only after histopathological confirmation.

Journal of Clinical and Diagnostic Research aims to publish findings of doctors at grass root level and post graduate students, so that all unique medical experiences are recorded in literature.

Introduction: Oral cancer, particularly oral squamous cell carcinoma (OSCC), is a significant global health issue, with India facing one of the highest incidence rates due to widespread tobacco and alcohol use. This study examines the impact of demographic factors, adverse habits, and socioeconomic status on the development and progression of OSCC among patients in Kolkata, India. Materials and Methods: A cross-sectional, observational study was conducted on 100 OSCC patients and 100 control subjects at a tertiary care centre in Kolkata over a year. Data were collected through structured questionnaires detailing demographic characteristics, adverse habits, socioeconomic status, and clinical presentations. Statistical analysis was performed using SYSTAT, with Student’s t-test, Chi-square tests, and one-way ANOVA used to assess associations between variables. Results: The mean age of OSCC patients was 53.5 years, and 65% were male. Tobacco and alcohol use were prevalent, with OSCC patients showing higher frequencies and longer durations of use compared to controls. Statistically significant associations were observed between OSCC diagnosis and both tobacco smoking and chewing habits (P < 0.05), as well as lower socioeconomic status. The mean presentation delay was 4.4 months, commonly due to initial consultations at non-specialized facilities and lack of awareness, with tongue lesions as the most frequent complaint site. Histopathologically, 57% of cases were poorly differentiated squamous cell carcinoma, often diagnosed at TNM Stage II. Conclusion: This study highlights that demographic factors, adverse habits, and socioeconomic status significantly influence OSCC risk and severity in Indian patients. The findings underscore the critical need for early detection initiatives, particularly in lower socioeconomic groups, and suggest that reducing tobacco and alcohol use can mitigate OSCC risk. Equipping the primary care physicians with the knowledge of primary prevention and enhanced public awareness are recommended to reduce presentation delays and improve patient outcomes.