Qualitative expression of hypoxia-inducible factor-1α in malignant transformation of oral submucous fibrosis: An immunohistochemical study

Background: Oral submucous fibrosis (OSF) is a precancerous condition predominantly seen in people of Asian descent. About 7%-12% of OSF patients develop oral squamous cell carcinoma. Morphological features of OSF, especially fibrosis, suggest a possibility of hypoxic environment in diseased tissues. Neovascularization and increased glycolysis, represent adaptations to a hypoxic microenvironment that are correlated with tumor invasion and metastasis. The adaptation of cells to hypoxia appears to be mediated through hypoxia-inducible factor-1α (HIF-1α). HIF-1α is said to be associated with malignant transformation of epithelium in other sites.

Aim: The aim of this study was to investigate the relationship between the expression of HIF-1α in OSMF and its role in malignant transformation.

Materials and methods: A retrospective study which included 20 histopathologically diagnosed cases of OSF was conducted. A qualitative evaluation of HIF-1α was performed. Statistical analysis was carried out using the IBM Statistical Package for Social Sciences 20.0 version (IBM Corporation, Armonk, NY, USA).

Results: Results showed an increased expression of HIF-1α in OSF.

Conclusion: HIF-1α appears to play a role in malignant transformation of OSF.

Keywords: Epithelial dysplasia; hypoxia; hypoxia-inducible factor-1α; malignant dysplasia; oral submucous fibrosis.