Morphological and Molecular Comparison of Entamoeba gingivalis Among Cancer Patients In Thi-Qar Province.
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2024-10-01
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Entamoeba gingivalis is a non-pathogenic ameba that inhabits the human oral cavity and occasionally other sites. Entamoeba gingivalis may become pathogenic in cancer patients under chemotherapy and causes periodontitis. The aim of this study was to compare the morphological and genetic diversity of E. gingivalis trophozoites isolated from cancer patients in Thi-Qar province who had healthy and diseased periodontal sites, for the period from August to December 2023.
A total of 300 swab samples were collected: 100 from cancer patients with periodontitis and 100 from cancer patients without periodontitis who visited the Thi-Qar Oncology center at Al-Haboubi Teaching Hospital and received chemotherapy. Furthermore, 100 swab samples were collected from healthy individuals, 50 having diseased periodontal sites and 50 with healthy periodontal sites, as a control group. Samples were diagnosed by microscopic staining with Giemsa stain and the recovered positive isolates were subjected to molecular analysis using 18 rDNA revealed PCR products with 204 pb size.
The overall infection rate of E. gingivalis was 46.33%. The results showed the size of trophozoite about 22–30 μm in periodontitis, while in without periodontitis was 18–25 μm, the results also showed the presence of cyst-like trophozoite of E. gingivalis were found in 7.19% of positive samples (n = 10/139), this phase was isolated for the first time in Iraq and the second study globally after a study in Germany.
The current study showed the prevalence of E. gingivalis among individuals with periodontitis these have a higher infection rate than those who without, in both the cancer patients (62% and 34%, respectively) and in healthy individuals (56% and 30%, respectively).The prevalence of E. gingivalis between males and females, in all groups. The prevalence of E. gingivalis in individuals with diabetes were greater than without diabetes, in both the cancer patients (72.22% and 42.68%, respectively) and healthy individuals (68.18% and 35.89%, respectively).
The percentage of E. gingivalis infections in individuals with tonsilitis, dental caries or halitosis these have a higher infection rate than those who without tonsilitis, dental caries or halitosis, in both the cancer patients and healthy individuals.The prevalence of E. gingivalis in individuals smokers were greater than not smokers, in both the cancer patients (61.90% and 44.30%, respectively) and healthy individuals (58.62% and 36.61%, respectively).
The prevalence of E. gingivalis in both cancer patients and control group by education level, observed that the primary education level had the highest infection rate 56.41% and 52.78%, respectively, and the lowest rate of infection in the university education level 37.50% and 34.28%, respectively. In the current results observed that the bad oral hygiene had the highest infection rate, and the lowest rate of infection in who use salt and toothpaste.
The prevalence of E. gingivalis among cancer patients in rural were greater than urban which where 56 % and 40 % respectively, also in control group were 48 % and 38 % respectively, the results showed that the infection rate was higher in patients with blood pressure than without blood pressure, where the infection rates in cancer patients were 56.67% and 44.29 %, respectively, also in healthy individuals were 51.85% and 39.73%, respectively.
The results showed that the prevalence of E. gingivalis was highest in the age group ≥61 and lowest in the age group ≤30 for both cancer patients and the control group, regardless of whether they had periodontitis or not. The prevalence of E. gingivalis is highest among people who received 21-25 doses of chemotherapy, followed by people who received 16-20 doses, and the lowest infection rate was among people who received 6-10, and the rates were as follows: 54.55 %, 53.33%, and 44.44%, respectively.
The E. gingivalis infection based on type of cancer, the current study showed the overall rate of infection of E. gingivalis by PCR technique was 66.13%.This study showed the sequence was identical and there was no difference in sequence between all isolates.
The results indicate that there exists significant differences (p<0.05 and CalX2>TabX2) in periodontitis, diabetes, age, oral hygiene, education level, tonsilitis, smokers, dental caries and halitosis.
The results demonstrate that there are no significant differences (p>0.05 and CalX2<TabX2) in sex, blood pressure and type of cancer