Morphometric Analysis in Potentially Malignant Head and Neck Lesions: Oral Submucous Fibrosis

Objective: The objective of this study is to analyze cases of oral submucous fibrosis (OSMF) Grade I, II, IIIand IV morphometrically with regard to epithelium, vasculature and fibrosis and determine any correlationwith histological grading after Pindborg and Sirsat. Materials and methods: Eighty three oral submucous fibrosiscases were analyzed morpometrically using an interactive image analysis system in the Department of Pathology,M.L.N Medical College, Allahabad, U.P, India. Paraffin embedded sections of 3-4 μm thickness were stainedwith hematoxylin/eosin, Van Gieson’s picric acid and acid fuchsin stain and Masson’s trichrome stains. Imageanalysis was performed with specific software (Image –Pro Plus 6.0) and data obtained were finally transportedto Excel sheets for calculation of average values for each parameter.
Results:With the grading criteria applied,9 cases of OSMF were grade I, 32 grade II, 39 grade III and 3 grade IV. Clinical trismus was most frequent inGrade IV followed by Grade III, II and I respectively. OSMF Grade I cases did not show any measurableamount of collagenization, whereas it showed a significant increase with OSMF I and II grades [Pearson’s χ2test= 85.72; p= 0.051] and OSMF-III and IV [Pearson’s χ2test=188.74; p< 0.001]. Numbers of endothelial cellsper low power field consistently decreased with the increasing grade.
Conclusions: We concluded that meanblood vessel area and the mean vessel diameter showed a marked increase in grade II and a marker decrease ingrade IV and the grade III, collagen thickness (μm) increases according to increasing grade while density ofendothelial cells decreases .