Estimation of serum lipid and lipoproteins in oral squamous cell carcinoma and potentially malignant disorders

Introduction: Changes in the lipid profile are said to be associated with oral cancer and potentially malignant disorders. Incidence of cancer has been reported to be more in patients with reduced cholesterol levels. Patients with oral cancer with reduced cholesterol are said to be having higher mortality. We carried out a hospital based case control prospective study to assess the relationship between lipid profile and oral squamous cell carcinoma and potentially malignant disorders (leukoplakia and OSMF). Aim and objective: To evaluate alteration of serum lipid profile in oral squamous cell carcinoma and potentially malignant disorders (leukoplakia and OSMF). Material and method: The study consisted of 50 patients each of oral squamous cell carcinoma and potentially malignant disorders (30 OSMF & 20 Leukoplakia) and 50 controls. Lipid profile included analysis of total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), very low density lipoprotein cholesterol (VLDL), triglycerides (TGL) and ratio of high and low density lipoprotein cholesterol. Lipid profiles were measured using the standard reagents. Result and observation: We found TG, LDL & VLDL were more in males in all the 3 groups. TC and HDL was highest in the females, however it was found to be higher than males in all the three groups but were non significant. A significantly reduced serum level of HDL, VLDL, TGL, TC and LDL were also reduced in the disease groups. When we correlated histological grading and lipid profile, well differentiated OSCC had low TC, and HDL, moderately differentiated had increased TG, LDL, and VLDL. TGL were highest in patients who had mildly dysplastic leukoplakia and lowest TC, while, moderate dysplasia cases had highest TC and lowest Tg, LDL, VLDL, HDL. Also in OSMF, most cases showed early changes (65%) and 35% cases showed moderately advanced changes. TC, Tg, LDL, VLDL, HDL levels were lowest compared to moderately advanced stage. Conclusion: The reduced levels of lipid profile in cases of OSCC could be due to the increased utilization of cholesterol by the cancer cells and in case of potentially malignant disorders this could be due to tobacco habits that reduced the lipid fractions. The reduced levels of lipids in leukoplakia and OSMF could be used to assess the malignant transformation that could help in early detection and prevent the progression to carcinoma.