Mitochondrial Dysfunction in Oral Carcinogenesis: Insights from Exfoliative Cytology

Abstract

Background: Oral squamous cell carcinoma (OSCC), a growing global health concern, is often preceded by oral potentially malignant disorders (OPMDs). Emerging evidence suggests mitochondrial dysfunction is crucial in carcinogenesis, affecting malignancy’s aggressiveness. This study uses Janus Green B (JGB) staining to investigate mitochondrial dysfunction in OPMDs and OSCC and examines its relationship with tobacco exposure to better understand its etiopathogenesis. Materials and Methods: Utilizing the exfoliative cytology technique, thirty buccal smears of epithelial cells from normal, OPMD and OSCC samples were collected and subjected to JGB staining. The intensity of staining and the total percentage of positively stained cells were quantified and subsequently correlated with clinicopathological parameters. Results: The mean values of varying grades of staining intensity including mild, moderate, and high as well as the total percentage of positive cells, demonstrated statistically increased significant differences among control, OPMD, and OSCC cases. Additionally, moderate, high-grade staining intensity and the total positive stained cells exhibited significant correlations with tobacco use frequency and duration. A cut-off value of 44.31 and 51.32 of JGB-positive cells was found to categorize the cases into high-risk OPMDs and OSCC transformation. Conclusion: The progressive increase in staining intensity and the number of positive cells from OPMDs to increasing histopathological grades of OSCC highlights mitochondrial dysfunction as a key factor in oral carcinogenesis and a reliable indicator for assessing malignant transformation in OPMDs and aggressive potential in OSCC. Furthermore, the study underscores tobacco as a primary cause of mitochondrial dysfunction in both OPMDs and OSCC. © Association of Otolaryngologists of India 2025.