Real-Time PCR Detection of Candida Species in Biopsy Samples from Non-Smokers with Oral Dysplasia and Oral Squamous Cell Cancer: A Retrospective Archive Study

SIMPLE SUMMARY: The current investigation utilized Real-Time PCR to detect the presence of five distinct Candida sp. in oral biopsy tissue samples obtained from non-smoker patients with dysplasia, carcinoma in situ, OSCC, and histologically benign lesions. Our results demonstrated a significant increase in the levels of C. albicans and C. tropicalis in the mild/moderate dysplasia group when compared to both the healthy group and the carcinoma in situ and OSCC cohorts. We noted a consistent coexistence of these two microorganisms, suggesting a potential shift from a commensal state to an opportunistic pathogen, particularly in relation to the onset of oral neoplasia. ABSTRACT: The impact of Candida sp. in the development of oral cancer remains uncertain and requires sensitive analytical approaches for clarification. Given the invasive capabilities of these microorganisms in penetrating and invading host tissues through hyphal invasion, this study sought to detect the presence of five Candida sp. in oral biopsy tissue samples from non-smoker patients. Samples were obtained from patients at varying stages of oral carcinogenesis, including dysplasia, carcinoma in situ, OSCC, and histologically benign lesions, and analyzed using Real-Time PCR. Oral tissue samples from 80 patients (46 males and 34 females) were included. Significantly higher C. albicans presence was detected in the mild/moderate dysplasia group compared to the healthy (p = 0.001), carcinoma in situ (p = 0.031) and OSCC groups (p = 0.000). Similarly, C. tropicalis carriage was higher in tissues with mild/moderate dysplasia compared to healthy (p = 0.004) and carcinoma in situ (p = 0.019). Our results showed a significant increase in the presence of C. albicans and C. tropicalis within the mild/moderate dysplasia group compared to other cohorts. Coexistence of these two microorganisms was observed, suggesting a potential transition from a commensal state to an opportunistic pathogen, which could be particularly linked to the onset of oral neoplasia.