The role of differentiated dysplasia in the prediction of malignant transformation of oral leukoplakia.

Autor: Wils LJ; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.; Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands., Poell JB; Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands.; Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Peferoen LAN; Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology, Amsterdam, The Netherlands., Evren I; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands., Brouns ER; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands., de Visscher JGAM; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands., van der Meij EH; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands., Brakenhoff RH; Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands.; Otolaryngology and Head & Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Bloemena E; Oral and Maxillofacial Surgery and Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Amsterdam UMC Location Vrije Universiteit Amsterdam, Pathology, Amsterdam, The Netherlands.; Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.; Cancer Center Amsterdam (CCA), Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology [J Oral Pathol Med] 2023 Nov; Vol. 52 (10), pp. 930-938. Date of Electronic Publication: 2023 Sep 25.
DOI: 10.1111/jop.13483
Abstrakt: Objective: Oral leukoplakia is the most common oral potentially malignant disorder. Malignant transformation of oral leukoplakia occurs at an annual rate of 1%-7%. WHO-defined classic epithelial dysplasia is an important predictor of malignant transformation of oral leukoplakia, but we have previously shown in a proof of concept study that prediction improves by incorporation of an architectural pattern of dysplasia, also coined as differentiated dysplasia. We aimed to analyze this finding in a larger cohort of patients.
Method: For this retrospective study 176 oral leukoplakia patients were included. Biopsies for all patients were assessed for the presence of dysplasia and analyzed for cytokeratin 13 and 17 expression. Moreover, the inter-observer agreement for the diagnosis of differentiated dysplasia was determined.
Results: In total, 33 of 176 patients developed oral squamous cell carcinoma during follow-up. Presence of classic epithelial dysplasia increased cancer risk two-fold (HR = 2.18, p = 0.026). Lesions without classic epithelial dysplasia could be further risk-stratified by the presence of differentiated dysplasia (HR = 7.36, p < 0.001). Combined classic epithelial and differentiated dysplasia imparted a seven-fold increased risk of malignant transformation (7.34, p = 0.001). Inter-observer agreement for the diagnosis of dysplasia, including differentiated dysplasia, was moderate (κ = 0.56, p < 0.001).
Discussion: This study emphasizes the importance of the recognition of the architectural pattern of differentiated dysplasia as a separate entity for risk prediction of malignant transformation of oral leukoplakia. Presence of any pattern of dysplasia results in accurate prediction of malignant transformation risk of oral leukoplakia.
(© 2023 The Authors. Journal of Oral Pathology & Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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