Periodontal Pathogens In Oral Squamous Cell Carcinoma Tissue: A PCR-Based Case-Control Study

Abstract

Background: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity, and increasing evidence suggests that periodontal dysbiosis may contribute to its development and progression. Periodontal pathogens may influence carcinogenesis through chronic inflammation, altered immune responses and microbial interactions within the tumour microenvironment.

Aim: To evaluate the prevalence and burden of selected periodontal pathogens in OSCC tissue and to compare them with non-malignant oral tissue using polymerase chain reaction (PCR).

Materials and Methods: This hospital-based case-control study included 40 participants at a tertiary care hospital, comprising 20 histopathologically confirmed OSCC patients and 20 non-malignant controls. Demographic characteristics, tobacco use, smoking, alcohol consumption and periodontal parameters including Plaque Index, Gingival Index, bleeding on probing, probing pocket depth and clinical attachment loss were recorded. Tissue samples were subjected to species-specific PCR for Porphyromonas gingivalis, Fusobacterium nucleatum, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans. Data were analysed using IBM SPSS Statistics version 27.0, with p<0.05 considered statistically significant.

Results: Tobacco chewing was significantly more frequent among OSCC cases than controls (80.00% vs 35.00%; p=0.010). All periodontal parameters were significantly higher in OSCC patients (p<0.001). Porphyromonas gingivalis was detected in 75.00% of cases versus 35.00% of controls (p=0.025), Fusobacterium nucleatum in 80.00% versus 40.00% (p=0.022), and Treponema denticola in 55.00% versus 20.00% (p=0.048). At least one periodontal pathogen was identified in 95.00% of OSCC tissues compared with 60.00% of controls (p=0.020). Two or more pathogens were detected in 85.00% versus 40.00% (p=0.008). High pathogen burden was significantly associated with advanced TNM stage (p=0.019) and lymph-node positivity (p=0.020).

Conclusion: OSCC tissues demonstrated significantly greater periodontal pathogen prevalence and polymicrobial burden than non-malignant tissues. The association of high pathogen burden with advanced stage and nodal involvement suggests that periodontal dysbiosis may be linked with OSCC severity.