Key result
In a systematic review of 13 studies comprising 607 cases, vascularity decreased as the histological stage of oral submucous fibrosis advanced in more than half of the evaluated studies.
Why the study?
Recent studies showed no significant change in vascularity across advancing stages of oral submucous fibrosis, contrasting with conventional concepts.
Does vascularity change with advancing histological grades of oral submucous fibrosis?
Systematic Review (n=607)
Does vascularity change with advancing histological grades of oral submucous fibrosis?
The systematic review supports the concept that vascularity decreases with advancing stages of oral submucous fibrosis, potentially contributing to malignisation by prolonging carcinogen exposure in compromised epithelium.
Vascularity decline in advancing OSMF may elevate malignancy risk; supports progression marker role but requires prospective validation before clinical adoption.
Objectives: This study aimed to quantify the vascularity in histological grades of oral submucous fibrosis (OSMF) and to determine if there is any connection between vasculogenesis and malignisation. Recent studies show no significant change in vascularity as the stage advances as opposed to the conventional concept. Methods: A comprehensive database search until December 2022 was conducted for published articles on vascularity in OSMF following preferred reporting items for systematic reviews and meta-analyses guidelines. Results: A total of 98 articles were screened of which 13 were included for systematic evaluation. The study included 607 cases, with a definite predilection for the male gender. Of the 13 studies, 11 evaluated mean vascular density. In more than half of the studies, the vascularity decreased as the stage advanced. Similar results were obtained for endothelial cells/μm2, mean vascular area percentage and mean vascular area. Conclusion: The present review supports the prevailing concept that vascularity decreases with the advancement of the OSMF stage. This denies the systemic absorption of carcinogens into the circulation with resultant longer exposure of compromised epithelium and malignisation.
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Pandiar et al. (2023) conducted a systematic review in Oral submucous fibrosis (OSMF) (n=607). Advancing histological grades of oral submucous fibrosis was evaluated on Vascularity (mean vascular density, endothelial cells/μm2, mean vascular area percentage and mean vascular area). In a systematic review of 13 studies comprising 607 cases, vascularity decreased as the histological stage of oral submucous fibrosis advanced in more than half of the evaluated studies.
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