A comparative study of Candida species diversity among patients with oral squamous cell carcinoma and oral potentially malignant disorders

Abstract

Objectives: To determine the prevalence of Candida species by PCR-RFLP method in the saliva of patients with oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMD) and healthy cohorts. Unstimulated saliva was collected from patients with OSCC (n = 97), OPMD (n = 200), and healthy controls (n = 200). Candida species were isolated using the standard protocol. The isolates were identified using phenotypic and genotypic methods. The odds/risk ratio was calculated using Pearson's Chi-square test. The significance of Candidal carriage was calculated by independent T-test.

Results: Oral Candidal carriage was 72.2%, 58% and 20.5% among patients with OSCC, OPMD, and healthy controls respectively. The oral Candidal carriage in OSCC and OPMD was highly significant (p = 0.0001). Non albicans Candida predominated over Candida albicans. Candida species were diverse among the study groups with a predominance of Candida krusei, Candida tropicalis, and Pichia anomala formerly Candida pelliculosa. P. anomala occurrence outnumbered in health. The odds/risk ratio for OSCC and OPMD were 4.25/11.87 and 3.52/6.99 respectively. A high prevalence of non albicans Candida was observed both in all the three groups (OSCC, OPMD and healthy controls). High odds and risk ratio associates Candida species to OSCC and OPMD. Candida famata may be associated with OSCC and OPMD.

Keywords: Candida; Oral potentially malignant disorder; Oral squamous cell carcinoma; Polymerase chain reaction; Restriction fragment length polymorphism.

Fig. 1

Gel electrophoresis picture showing the PCR amplicons of varied Candida species

Fig. 2

Gel electrophoresis picture showing the PCR fragments of restriction digestion with MspI restriction enzyme