Byakodi Raghavendra, Krishnappa R, Keluskar Vaishali, Bagewadi Anjana, Shetti Arvind
Department of Oral Medicine and Radiology, Bharati Vidyapeeth Deemed University, Dental College and Hospital Sangli, Maharastra, India.
Quintessence Int. 2011 Oct;42(9):e118-23.
Changes in the microbial flora on the oral mucosa after cancerous alteration may lead to both local and systemic infections. In this study, we assessed the microbial flora associated with the surfaces of oral squamous cell carcinoma. A comparative evaluation of these microbial contents was made with that of the contralateral healthy mucosa and control (healthy) mucosa. We also assessed the microbial flora from the saliva culture in subjects with oral squamous cell carcinoma and healthy controls.
The case control study was made up of 30 subjects with oral squamous cell carcinoma as the study group; 30 healthy age-, sex-, habit-, and dentition-matched subjects served as the control group. In the study group, microbial samples were collected from the carcinoma site, contralateral healthy mucosa, and saliva, whereas in the control group, samples were collected from the healthy mucosa and saliva. These samples were stored on ice and subsequently transported to the laboratory in 2 mL of thioglycollate transport media, where the microbial cultures were carried out.
Oral squamous cell carcinoma sites harbor significantly more microbial flora (bacteria and yeasts) compared to those of healthy mucosa (control group). The microbial flora predominantly isolated from the carcinoma site were Streptococcus species, Staphylococcus species, Moraxella species, Enterococcus feacalis, Aerobic spore bearers, Klebsiella species, Citrobacter species, Proteus species, Pseudomonas species, and Candida albicans. The median number of colony forming units (CFU)/mL at carcinoma sites (3.85 x 105 CFU/mL) was significantly higher than that of the healthy mucosa (0.571 x 105 CFU/mL; P = .0000, Wilcoxon nonparametric test). Similarly, in saliva of carcinoma subjects, the median number of CFU/mL (2.408 x 105 CFU/mL) was significantly higher than that of saliva in control subjects (0.78 x 105 CFU/mL; P = .0000, Wilcoxon nonparametric test).
The present study clearly indicates that the subjects with oral squamous cell carcinoma harbor significantly more microbial flora. Emphasis has to be given to preventing microbial flora in the oral cavity and treating these patients with appropriate antimicrobial agents, thus reducing their morbidity.
癌性改变后口腔黏膜微生物群的变化可能导致局部和全身感染。在本研究中，我们评估了与口腔鳞状细胞癌表面相关的微生物群。对这些微生物成分与对侧健康黏膜和对照（健康）黏膜的微生物成分进行了比较评估。我们还评估了口腔鳞状细胞癌患者和健康对照者唾液培养中的微生物群。
病例对照研究由30名口腔鳞状细胞癌患者作为研究组组成；30名年龄、性别、习惯和牙列匹配的健康受试者作为对照组。在研究组中，从癌灶、对侧健康黏膜和唾液中采集微生物样本，而在对照组中，从健康黏膜和唾液中采集样本。这些样本保存在冰上，随后在2 mL硫乙醇酸盐转运培养基中运至实验室，在那里进行微生物培养。
与健康黏膜（对照组）相比，口腔鳞状细胞癌部位的微生物群（细菌和酵母菌）明显更多。主要从癌灶分离出的微生物群有链球菌属、葡萄球菌属、莫拉菌属、粪肠球菌、需氧芽孢杆菌、克雷伯菌属、柠檬酸杆菌属、变形杆菌属、假单胞菌属和白色念珠菌。癌灶部位的菌落形成单位（CFU）/mL中位数（3.85×10⁵ CFU/mL）显著高于健康黏膜（0.571×10⁵ CFU/mL；P = 0.0000，Wilcoxon非参数检验）。同样，在癌症患者的唾液中，CFU/mL中位数（2.408×10⁵ CFU/mL）显著高于对照组受试者的唾液（0.78×10⁵ CFU/mL；P = 0.0000，Wilcoxon非参数检验）。
本研究清楚地表明，口腔鳞状细胞癌患者体内的微生物群明显更多。必须重视预防口腔中的微生物群，并使用适当的抗菌药物治疗这些患者，从而降低其发病率。
