Evaluation of plasma fibrinogen degradation products, D-dimer, and mast cells in oral submucous fibrosis

Abstract

Background: Oral submucous fibrosis (OSF), a premalignant condition, demands early diagnosis and treatment for an improved prognosis of the patients. Being a chronic inflammatory disease, various markers of inflammation can be used to predict the prognosis of the disease. The present study was undertaken to assess the plasma levels of fibrinogen degradation products (FDPs), D-dimer, and mast cell density (MCD) in patients with OSF. Materials and Methods: Forty histopathologically confirmed cases of OSF and 10 age- and sex-matched individuals were included in the study. Two ml of venous blood was obtained from all the study participants and was evaluated for the levels of FDPs, d-dimer, and mast cell densities. Results: Comparison of mean plasma levels of FDPs and D-dimer showed a statistically significant increase with the increase in the grades of OSF. Also, a significant association was evident between the plasma FDPs and D-dimer levels. The values of mean mast cell densities from grade I to grade IV OSF were 191.1/mm2, 258.5/mm2, 182.4/mm2, and 165.7/mm2, respectively, and were significantly higher than the value in NOM i.e., 86.5/mm2. There was a statistically significant increase in the values of mast cell densities from grade I to grade II OSF, with grade II OSF showing the highest mast cell densities among all the grades, and the values decreased toward grades III and IV OSF, with grade IV showing the least mast cell densities. Conclusion: Excessive areca nut chewing may stimulate collagen synthesis by fibroblasts, enhancing fibrosis, and in turn, raising the plasma fibrinogen levels and thereby the FDPs and d-dimers associated with the advancement of the grade of OSF.