Detection of apoptotic cells in whole saliva of patients with oral premalignant and malignant lesions: A preliminary study

Objective. The purpose of this study was to identify and measure apoptotic cells in whole saliva of patients with oral premalignant and malignant lesions and explore its utility as a prognostic indicator. Study design. A fluorescent TUNEL technique (APO-BrdU TUNEL) modified by our lab was applied to unstimulated whole saliva from 8 healthy volunteers, 16 patients with oral leukoplakia and/or lichen planus, 10 untreated and 5 treated cases with oral malignant lesion. Results. The apoptotic cells in whole saliva were detected in 4 groups of study subjects. The apoptotic cells demonstrated morphology similar to normal exfoliated epithelial cells of oral mucosa. The fraction of apoptotic cell in treated malignant patients (18.18 +/- 12.65) was significantly higher than that in healthy volunteers (6.99 +/- 6.52), premalignant patients (4.43 +/- 5.52), and untreated malignant patients (3.40 +/- 5.14) (P < .05). Conclusion. Detection of apoptotic epithelial cells in whole saliva appears to have some clinical potential in monitoring reaction to chemoradiotherapy and may reveal some insight into the mechanism of oral carcinogenesis.