Isolation and Identification Of Candida Albicans In Smokers With Epithelial Dysplasia And Squamous Cell Carcinoma: A Histopathological Correlation

Background:Greater adaptability of Candida to the host niche makes it the most common opportunistic pathogen. Its role as a commensal or pathogen in development of premalignancies and its progression to malignancies is of considerable debate. Present study was undertaken to determine the role of Candida albicans(CA)in progressionof oral cancer by isolation and identification by mycological methods in smokers without oral lesions and histopathologically diagnosed cases of epithelial dysplasia (ED) and oral squamous cell carcinoma (OSCC). Methodology:The study comprised of 120 cases that included study group of 40 smokers with oral lesions, 40 smokers without oral lesions and 40 non-smokers as control group. Clinical examination was followed by oral rinse sample collection and biopsy for histopathological confirmation. Sedimented oral rinse was inoculated on Sabouraud’s dextrose agar (SDA). Isolated Candida colony after identification with Gram stain was subjected to germ tube and chlamydospore formation test for confirmation of CA. The data was statistically analysed using chi square test. Results:Colonisation of CA was 52.5% in the study group and 5% in the control group, was found to be statistically significant (p<0.001).Association of CA in smokers with varying histopathologic grades of oral lesions showed no evidence of a correlation. However, positive correlation was found in OSCC (n=19, 95%) and showed statistical significance (p<0.001). Conclusion:The present study showed an increase in colonization of CA in malignant lesions suggesting that CA in conjunction with tobacco usage may play a role in oral carcinogenesis.