title: Clinicopathologic evaluation of lesions associated with tobacco usage.
abstract: BACKGROUND
  Tobacco usage in different forms is the single most common etiological factor responsible for oral cancers. The aim of the present study was to record various mucosal lesions associated with tobacco usage and to ascertain the prevalence of dysplasia in them by histopathological evaluation and to compare the extent of dysplastic features seen among patients associated with a habit of smoked and smokeless form of tobacco.
  
  
  METHODS
  Seventy-six patients with the clinical diagnosis of tobacco related lesions (Leukoplakia, Erythroplakia, Nicotina stomatitis, Tobacco pouch keratosis) were selected. A detailed description of the clinical presentation of the lesion was noted and the patients were subjected to incisional biopsy followed by a histopathological evaluation.
  
  
  RESULTS
  Showed dysplastic changes in 50 cases (65.8%) ranging from mild dysplasia in 27 cases (35.5%), moderate dysplasia in 17 cases (22.4%) and 6 cases (7.9%) showed severe dysplasia. Moderate to severe dysplasia was 1.83 times more likely to occur with smokeless tobacco usage when compared to smoked form. Data obtained from this study reveals that patients with a duration of tobacco usage more than 10 years were 2.17 times more likely to have moderate to severe dysplasia (p = 0.154).
  
  
  CONCLUSIONS
  Thus, the study highlights the role of oral physicians in detecting oral mucosal lesions and screening high-risk patients on a regular basis and also reaffrms the importance of public education, stressing the risk factors for oral cancers.
authors.affiliation: Associate Professor, Department of Oral Medicine and Radiology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India, e-mail: saisamata@gmail.com.
authors.forename: Yalamanchili
authors.initials: Y
authors.lastname: Samatha
authors.affiliation: Professor and Head, Department of Pedodontics and Preventive Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India.
authors.forename: Avula Jogendra Sai
authors.initials: AJ
authors.lastname: Sankar
authors.affiliation: Former Principal and Head, Department of Oral Medicine and Radiology, The Oxford Dental College and Research Centre, Bengaluru, Karnataka India.
authors.forename: K S
authors.initials: KS
authors.lastname: Ganapathy
authors.affiliation: Professor, Department of Oral Medicine and Radiology, ACES Maruthi Dental College, Bengaluru, Karnataka, India.
authors.forename: Kandula
authors.initials: K
authors.lastname: Srinivas
authors.affiliation: Resident, Department of Oral Medicine, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India.
authors.forename: Dasari
authors.initials: D
authors.lastname: Ankineedu
authors.affiliation: Private Practitioner, Guntur, Andhra Pradesh, India.
authors.forename: Alluri Leela Subhashini
authors.initials: AL
authors.lastname: Choudary
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D002278:Carcinoma in Situ / Q000473:pathology; D004919:Erythroplasia / Q000473:pathology; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000473:pathology*; D009538:Nicotine / Q000009:adverse effects; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects; D013280:Stomatitis / Q000473:pathology; D013997:Time Factors; D064424:Tobacco Use / Q000009:adverse effects*; D014030:Tobacco, Smokeless / Q000009:adverse effects
chemical_list: D009538:Nicotine