Differences in oral habit and lymphocyte subpopulation affect malignant transformation of patients with oral precancer

• Published in: Journal of the Formosan Medical Association Vol. 115; no. 4; pp. 263 - 268
• Main Authors: Yeh, Chien-Yang, Lin, Chien-Ling, Chang, Mei-Chi, Chen, Hsin-Ming, Kok, Seng-Heng, Chang, Shu-Hui, Kuo, Ying-Shiung, Hahn, Liang-Jiunn, Chan, Chiu-Po, Lee, Jang-Jaer, Jeng, Jiiang-Huei
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.04.2016; Elsevier
• Subjects: Adult; Alcohol Drinking - epidemiology; Areca - adverse effects; B-Lymphocytes - immunology; Biomarkers - analysis; Carcinoma, Squamous Cell - epidemiology; Humans; Internal Medicine; Killer Cells, Natural - immunology; lymphocyte population; Lymphocyte Subsets - immunology; Male; malignant transformation; Middle Aged; Mouth Neoplasms - epidemiology; Mouth Neoplasms - etiology; oral cancer; oral habits; Smoking - epidemiology; Taiwan - epidemiology; malignant transformation; lymphocyte population; oral cancer; oral habits
• ISSN: 0929-6646
• DOI: 10.1016/j.jfma.2015.07.017

Abstract Background/purpose In Taiwan, the combination of betel quid chewing, alcohol consumption, and smoking habits increases oral cancer risk by 123-fold compared to persons without these habits. Lymphocyte populations in patients may potentially affect the malignant transformation of oral precancer. Methods A total of 28 patients with oral precancer from our previous cohort were enrolled in this study, and their personal information and oral habits were documented. Their lymphocyte populations (CD4+, CD8+, CD19+, and CD56+) and activation markers (CD25 and CD69) were determined by flow cytometry from 1999 to 2004. After follow up till December 2014, data of patients with/without malignant transformation were recorded, and the relation between oral habits and percentage of initial lymphocyte markers was evaluated using the Student t test and Fisher's exact test. Results Ten precancer patients developed oral squamous cell carcinoma with a mean period of malignant transformation of 6.8 ± 2.1 years. Patients with malignant transformation had a mean age of 48.4 ± 5.0 years ( n  = 10), relatively more than that of patients without malignant transformation (41.6 ± 6.3 years, n  = 18) ( p  < 0.05). An increase was noted in the population of peripheral blood mononuclear cells expressing CD4+CD69+, CD19+CD69+, and CD56+CD69+ ( p  < 0.05) in precancer patients with malignant transformation. Alcohol consumption showed an association with the malignant transformation of patients with precancer (p  = 0.030 ) , whereas betel quid and smoking showed little effect. Conclusion These results suggest that age, alcohol consumption, and early activation of T cells, B cells, and natural killer cells are crucial in the malignant transformation of oral precancer. Analysis of patient's lymphocyte populations may help predict the malignant transformation of oral precancer.