title: Relationship between thickness of fibrosis and epithelial dysplasia in oral submucous fibrosis.
abstract: OBJECTIVE
  Although oral submucous fibrosis is characterized by fibrosis of the subepithelial connective tissue, the overlying epithelial changes contribute to malignant transformation. Therefore, the aim of the study was to evaluate the relationship between thickness of fibrosis and epithelial changes in oral submucous fibrosis.
  
  
  METHODS
  The relationship between thickness of fibrosis and presence or absence of epithelial dysplasia was evaluated in 107 biopsies containing histopathologically-confirmed oral submucous fibrosis. The results were analyzed using Student's t-test or χ(2) -test.
  
  
  RESULTS
  Fifty-seven percent (61/107) of oral submucous fibrosis lesions showed a non-dysplastic overlying epithelium, while 43% (46/107) showed varying degrees of epithelial dysplasia. The mean thickness of fibrosis of non-dysplastic lesions was 0.91±0.41 mm (mean ± standard deviation) and ranged from 0.25 to 1.9 mm. However, the mean thickness of fibrosis of dysplastic lesions was 1.17 ± 0.52 mm and ranged from 0.48 to 3 mm. The results revealed a significant increase in the incidence of epithelial dysplasia as the thickness of fibrosis increased (P = 0.004). As such, the lesions that showed increased fibrosis were more likely to present with epithelial dysplasia.
  
  
  CONCLUSIONS
  The advancement of fibrosis increases the risk of development of epithelial dysplasia in oral submucous fibrosis.
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Primali Rukmal
authors.initials: PR
authors.lastname: Jayasooriya
authors.forename: Kadawatha Arachchige
authors.initials: KA
authors.lastname: Nadeeka Jayasinghe
authors.forename: Wanninayaka
authors.initials: W
authors.lastname: Mudiyanselage Tilakaratne
mesh_terms: D000328:Adult; D002448:Cell Adhesion; D002466:Cell Nucleolus / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D016764:Cell Polarity; D048430:Cell Shape; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D002843:Chromatin / Q000473:pathology; D003238:Connective Tissue / Q000473:pathology; D003593:Cytoplasm / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008938:Mitosis; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology*; D009914:Oral Submucous Fibrosis / Q000473:pathology*; D011230:Precancerous Conditions / Q000473:pathology*
chemical_list: D002843:Chromatin
keywords: epithelial dysplasia; grading; hypoxia; oral submucous fibrosis; thickness of fibrosis