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VOLUME 7 , ISSUE 3 ( September-December, 2019 ) > List of Articles

Original Article

Association of Increased Red Cell Distribution Width with Malignant Transformation of Oral Submucous Fibrosis

Kundendu Arya Bishen, Sonam Gehi, Pratiksha Kumar, Anand Krishna Singh, Puneet Gupta

Keywords : blood indices, oral submucous fibrosis, red cell distribution width

Citation Information : Bishen KA, Gehi S, Kumar P, Singh AK, Gupta P. Association of Increased Red Cell Distribution Width with Malignant Transformation of Oral Submucous Fibrosis. 2019; 7 (3):123-127.

DOI: 10.1055/s-0040-1701146

License: CC BY-NC-ND 4.0

Published Online: 23-01-2020

Copyright Statement:  © 2019 Bhojia Dental College and Hospital affiliated to Himachal Pradesh University


Abstract

Introduction Oral submucous fibrosis (OSMF) is associated with nutritional deficiencies—primarily of iron and vitamins and usually seem to be associated with anemia. Red cell distribution width (RDW) is one of the routinely assessed parameters in complete blood picture analysis of any patient. It measures range of variation in erythrocyte size. A high RDW value has been associated to adverse outcomes in several diseases and risk of death. However, the relationship of RDW and OSMF is yet to be established. Aim To analyze the association of RDW levels and other erythrocytic indices with clinical staging and prognosis of OSMF patients. Materials and Methods Analysis of clinical stage and hematologic status of 86 patients comprising the study group (OSMF cases and OSMF with malignant changes) and control group was performed. It was done using Kruskal–Wallis analysis of variance test. Results The values of mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were below normal from the onset of oral submucous fibrosis and they continued to decrease as the disease progressed. On other hand, RDW values were found to be in normal range in initial stages of disease and they became high in stage IV OSMF and increased further in OSMF patients with malignant changes. Conclusion We observed that higher values of RDW are strongly and independently associated with OSMF and OSCC, suggesting that RDW may contribute as most economic novel biochemical marker for progression and malignant transformation of OSMF.


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  1. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169(5):515–523
  2. Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci 2010;65(3):258–265
  3. The anemia of chronic disorders: studies of marrow regulation and iron metabolism. Blood 1975;45(1):55–65
  4. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med 2005;118(11):1288
  5. Iron deficiency in oral submucous fibrosis: accelerator or a promoter? Int J Oral Maxillofac Pathol 2012;3(1):2–7
  6. An alternative pathogenetic pathway for oral submucous fibrosis (OSMF). Med Hypotheses 1989;30(1):35–37
  7. Studies on the hematologic profile and trace elements in oral submucous fibrosis. J Clin Biochem Nutr 1995;19(1):9–17
  8. Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg 1995;24(6):433–439
  9. Oral submucous fibrosis, a clinically benign but potentially malignant disease: report of 3 cases and review of the literature. J Can Dent Assoc 2008;74(8):735–740
  10. Oral submucous fibrosis. A review. Aust Dent J 1996;41(5):294–299
  11. The profile of red cell distribution width and some hematological parameters in patients of oral submucous fibrosis. J Oral Maxillofac Pathol 2014;18:S6
  12. Nutritional aspects of essential trace elements in oral health and disease: an extensive review. Scientifica (Cairo) 2016;2016:5464373
  13. Role of haematological profile in oral sub mucous fibrosis: a clinical study. J Adv Med Dent Sci Res 2015;3(4):6–8
  14. Iron and the oral epithelium: a review. J R Soc Med 1984;77(7):602–607
  15. Circulating immune complexes and trace elements (copper, iron and selenium) as markers in oral precancer and cancer: a randomised, controlled clinical trial. Head Face Med 2006;2:33
  16. Red cell distribution width (RDW) in the diagnosis of iron deficiency with microcytic hypochromic anemia. Indian J Pediatr 2009;76(3):265–268
  17. Anemia of chronic disease. N Engl J Med 2005;352(10):1011–1023
  18. Oxidation and erythrocyte senescence. Curr Opin Hematol 2000;7(2):113–116
  19. The domino effect: role of hypoxia in malignant transformation of oral submucous fibrosis. J Oral Maxillofac Pathol 2015;19(2):122–127
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