Bioimpedance Assessment of Oral Squamous Cell Carcinoma with Clinicopathological Correlation.

AIM: Molecular alterations at membrane, cytosol and nuclear level in cancer cells/tissue show variations in bioimpedance measure. In the present study, bioimpedance assessment and comparison was investigated between oral squamous cell carcinoma (OSCC) and normal tissue. Study further involves clinicopathological correlation of bioimpedance values in OSCC. MATERIALS AND METHODS: The present study is comprised of 50 OSCC cases and 50 healthy control subjects. Four electrical properties of OSCC were measured: Impedance (Z); Phase angle (9); Real part of impedance (R); and Imaginary part of impedance (X) at six frequencies: 20 Hz; 50 kHz; 1.3 MHz; 2.5 MHz; 3.7 MHz; and 5 MHz with the amplitude of the applied voltage limited to 200 mV. RESULTS: The bioimpedance of OSCC as well as control group decreased as the measurement frequency increased from 20 Hz to 5 MHz. The bioimpedance of OSCC was generally smaller than that of control group. The mean bioimpedance of OSCC was found to be 4493 +/- 216.9 Omega and 370.0 +/- 26.45 Omega and that of control group was 15490 +/- 287.2 Omega and 817.1 +/- 7.227 Omega at frequencies of 20 Hz and 50 MHz respectively which is statistically significant (p < 0.0001). The values of phase angle, real and imaginary part of impedance of OSCC group were found to be significantly larger than that of control group (p < 0.0001) at 20 Hz and 50 MHz frequency. Impedance values of OSCC were seen to decrease from stages I to IV. Statistically significant differences in values of impedance were observed between stage I (4881 +/- 262.5 Omega) and IV (4500 +/- 181.6 Omega) (p = 0.0060) and also between stage I (4881 +/- 262.5 Omega) and III (4376 +/- 121.3 Omega) at frequency of 20 Hz (p-value 0.0005). Statistically significant differences in values of impedance were also observed between well differentiated (4557 +/- 260.8) and poorly differentiated OSCC (4347 +/- 76.12) (p = 0.0004) but only at 20 Hz frequency. CONCLUSION: Bioimpedance at a particular frequency showed significant alteration in OSCC tissue as compared to control. Hence, it can be potentially promising detection technique for OSCC. CLINICAL SIGNIFICANCE: It is a low-cost real time method, which requires little training, and hence can be easily used in primary care centers or in developing countries where multiple challenges limit national screening programs.