Comparison of TLC (Total Leucocyte Count), Neutrophils and Monocytes in Oral Squamous Cell Carcinoma and Pre-malignant Disorders

Oral squamous cell carcinoma is one of the significant public health concerns and the most prevalent malignancies affecting the head and neck region globally. The primary risk factors for this cancer include tobacco usage, alcohol consumption and increasing incidence of human papillomavirus infections (HPV). The incidence of oral squamous carcinoma has been rising among young populations and the prognosis among young and older patients remains a debated issue. However, recent studies(1) found that there is no significant difference in tumor stage or grade based on age and the premalignant disorders represent an early stage in the evolution of cancer that characterized by molecular alterations and clonal expansions that progress to malignancy. This entails that age specifically is not a determining factor in aggressiveness and treatment outcomes of Oral squamous cell carcinoma, emphasizing the need to focus on other factors that influence prognosis of this condition(2).

Premalignant disorders may involve detectable molecular alterations in blood cells and tissues, somatic mutations in key genes included DNMT3A and TET2 have been recognized in leukocytes of healthy individuals indicating a risk of future malignancy. There is a growing area of research where a comparison of hematological parameters like Total leukocytes Count (TLC), neutrophils and monocytes in OSCC patients versus those with premalignant disorders. The measurement of these blood markers provides an insight into immune response and systemic inflammation associated with malignancy progression. The evaluation and finding of Total leukocytes count, neutrophils and monocytes offered important and valuable prognostic information and also helped in distinguishing between malignant and premalignant conditions in the population. The monitoring of genetic mutations in blood cells of individuals could provide a non-invasive method to identify individuals at risk and help in better outcomes(3).

The leukocyte counts particularly neutrophils, monocytes and total leukocytes count (TLC) have been investigated for cancer progression and patient immune response. Elevated levels of these blood cells have been observed in patients with oral squamous cell carcinoma indicating systemic inflammation and alterations in immune system that are associated with malignancy, whereas in premalignant conditions alterations in these parameters in the patients indicate immune response to cellular changes with key probable to predict malignant transformation. Comparing the levels of these blood counts in oral squamous cell carcinoma patients and those with premalignant lesions provide valuable awareness and insights into immunological, inflammatory processes involved in the early stages of cancer progression(4).

There are approximately 3% of all the malignancies affecting around 270,000 people globally in annual rate. A significant amount of proportion of oral squamous cell carcinoma cases develops from premalignant disorders of the oral cavity including leukoplakia and oral submucous fibrosis, which has very high rate of malignant transformation(5). Therefore, hematological parameters would be explored as potential biomarkers for early detection of OSCC and its prognosis. Studies have revealed that quantitative changes in blood biochemistry and hematology occur during tumor initiation and progression, highlighting their potential role as the tumor markers(6).

Therefore, despite the advancement of cancer therapy the prognosis of oral squamous cell carcinoma remained poor. This is largely due to the late diagnosis of the condition, however early detection is critical for improving patient outcomes and some recent research revealed various biomarkers and hematological parameters as a potential diagnostic tool and explored that immunological and hematological changes have been observed particularly alterations in total leukocyte count, neutrophils and monocytes and these changes have been investigated as an indicators of cancer progression. This underscores the importance of studying immune and also hematological detailed profiles in Oral squamous cell carcinoma and its precursor lesions(7).

The purpose of the study is to assess and compare particular hematological parameters in individuals with premalignant conditions and those with squamous cell carcinoma. The study focus on hematological profile specifically Total leukocyte count (TLC), neutrophil count and monocyte count. By comparing these hematological markers in the patients with oral squamous cell carcinoma and the patients with pre-malignant lesions, therefore this study seeks to identify a distinct pattern that distinguishes between malignant and premalignant conditions. This comparative study aims to understand immune and inflammatory profiles of patients between two groups of study participants.