title: Prevalence of Carcinomatous Foci in Oral Leukoplakia: A Clinicopathologic Study of 546 Indian Samples.
abstract: BACKGROUND
  Oral Leukoplakia (OL), the most common potentially malignant disorder, is diagnosed clinically on the basis of exclusion of other lesions. In a country like India, where prevalence of oral cancer is very high, the issue of carcinomatous foci within OL at the time of initial diagnosis of leukoplakia has never been addressed before.
  
  
  OBJECTIVE
  To estimate the prevalence and risk factors for epithelial dysplasia as well as carcinoma within OL lesions at the time of initial clinical presentation in an Indian population with high prevalence of tobacco use.
  
  
  METHODS
  Clinical and pathologic data (age, sex, lesion location and histopathologic grading) of 546 cases of leukoplakia were analyzed. The prevalence rate of dysplasia and carcinoma in 546 oral leukoplakia cases was calculated. Univariate analysis was performed to examine risk factors associated with the presence of carcinoma and dysplasia within the lesions.
  
  
  RESULTS
  The male to female ratio in this study was 2:1. Majority of the patients irrespective of sex had a history of tobacco use. Of the total 85% of non-homogeneous lesions and 70% for the homogeneous lesions were illustrating, features of epithelial dysplasia. The prevalence rate of carcinoma was 11.9%. In univariate analysis it was found that lesion site, clinical appearance, tobacco use were strongly correlated with the presence of carcinoma within OL.
  
  
  CONCLUSIONS
  Our results demonstrate that majority of leukoplakia irrespective of its clinical appearance contain a dysplastic component and significant proportion contains carcinomatous foci. Lesions with certain features are more prone to have carcinomatous foci. However there is always a chance of finding foci of carcinoma in OL anywhere in the oral cavity. Therefore, excision biopsy is always mandatory before long term follow-up and treatment is planned.
authors.affiliation: Senior Lecturer, Department of Oral Pathology and Microbiology, Malabar Dental College and Research Centre Edappal , Malappuram, Kerala, India .
authors.forename: Divya
authors.initials: D
authors.lastname: Gopinath
authors.affiliation: Professor and Head, Department of Oral and Maxillofacial Pathology, Government Dental College , Kottayam, Kerala, India .
authors.forename: Beena Valappil
authors.initials: BV
authors.lastname: Thannikunnath
authors.affiliation: Assistant Dental Surgeon, Taluk Hospital , Wandoor, Malappuram, Kerala, India .
authors.forename: Salmanul Faris
authors.initials: SF
authors.lastname: Neermunda
keywords: Leukoplakia turning malignant; Potentially malignant disorders; Premalignant lesions